People with sudden hearing loss who receive steroids within seven days are five times more likely to fully recover their hearing than those not given steroids, a new study shows.
It identified factors that predict full hearing recovery after a sudden drop in hearing, with the strongest predictor being steroid treatment within a week of sudden hearing decline.
A team of clinician scientists at University College London Hospitals (UCLH) collaborated with 240 junior doctors and undertook the largest study of adults who were seen with sudden hearing loss across 76 hospitals in England and Wales.
Analysis found patients who received treatment within seven days were five times more likely to fully recover their hearing compared to those who were not given steroids, even after accounting for all other patient and hearing loss factors.
Findings were reported on 5 September 2024 in JAMA Otolaryngology – Head & Neck Surgery.
Alarmingly about 40% of the patients missed out on receiving treatment within this critical window. The team at the National Institute for Health and Care Research (NIHR) UCLH Biomedical Research Centre (BRC) found that only about 60 per cent of the patients were treated in the timeframe.
Online tool to predict hearing recovery
As a result researchers developed an online tool based on data from the SeaSHeL (Sudden onset Sensorineural Hearing Loss) study that can predict the chance of full hearing recovery in adults presenting with sudden hearing loss.
The Seashel recovery calculator, freely available online to clinicians, estimates the chance of full hearing recovery based on five key patient and disease factors; age, presence or absence of heart disease, presence or absence of dizziness, the severity of hearing loss and whether steroid treatment has already been given.
The tool can help specialists and their patients make informed decisions about treatment and follow up plans.
The researchers said thousands of adults suddenly lost hearing each year in the UK. Many spontaneously recover but most do not and in those who do not, resulting hearing loss can lead to considerable disability. They said it remained unclear why some recovered hearing and others did not and there was uncertainty on how best to manage these patients.
Lead researcher, UCLH ENT surgeon Mr Nish Mehta, said: “Time is of the essence when it comes to restoring hearing after sudden hearing loss. It is important that patients who experience a sudden drop in their hearing seek urgent medical attention.
“It is also important that the medical teams who first see these patients either arrange appropriate urgent specialist review or consider steroid treatment if the specialist review is unlikely to occur within the appropriate timeframe.
“Consultations between specialists and patients can now benefit from precise predictions on the chance of full hearing recovery if our free online calculator is used. This information can be used to guide shared decision making between specialists and their patients regarding treatment and follow up plans.”
ENT surgeon Professor Anne Schilder, director of the UCLH BRC Hearing Health theme, said: “This study shows the power of collaborative research. It was uniquely delivered by junior doctors in NHS hospitals across England within the framework of the NIHR. The study answers questions that come up every day in the conversations between doctors and patients about sudden hearing loss.”
Professor Karl Peggs, UCLH director of research and director of the NIHR UCLH BRC, said: “This study is one among several led by our BRC Hearing Health theme which is pushing forward our understanding of hearing loss and is an example of research led by our BRC which has huge potential to make real impact if its findings are taken up in the healthcare system.”
Joint first authors were ENT trainees Mr Rishi Mandavia and Mr Nikhil Joshi at UCLH who coordinated the work of teams from hospitals across England. The study was conducted using the expertise of senior researcher Mr Gerjon Hannink of the Radboud Institute for Health Science at Radboud University Medical Centre in Nijmegen, the Netherlands,
Ms Franki Oliver, audiology manager at the UK’s Royal National Institute for Deaf people, said receiving treatment soon increased chances of recovering hearing and patients should contact their GP, call an ambulance or go to a hospital emergency department.
“This research confirms that if you suddenly lose your hearing – either in one or both of your ears – getting treatment quickly is key,” she said. “Sudden hearing loss is not always serious but it could be a medical emergency.”
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