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. 2021 Apr 1;50(1):22.
doi: 10.1186/s40463-021-00498-x.

Management of sudden sensorineural hearing loss among primary care physicians in Canada: a survey study

Benjamin Ng  1 , Matthew G Crowson  2   3 , Vincent Lin  4
Affiliations

Management of sudden sensorineural hearing loss among primary care physicians in Canada: a survey study

Benjamin Ng et al. J Otolaryngol Head Neck Surg. .

Abstract

Background: Sudden Sensorineural Hearing Loss (SSNHL) is a medical emergency requiring immediate attention as delayed treatment can lead to permanent and devastating consequences. Primary care physicians are likely the first to be presented with SSNHL and therefore have the crucial role of recognizing it and initiating timely and appropriate management. The aim of this study was to gain insight into the current knowledge and practice trends pertaining to the diagnosis and management of SSNHL among family physicians in Canada.

Methods: An 18-question survey targeting Canadian family physicians was marketed through two, physician-only discussion groups on the social media platform Facebook. Responses were collected between August 1st and December 22nd 2019 then aggregated and quantified.

Results: 52 family physicians submitted responses. 94.2% (n = 49) reported that in their practice, unilateral SSNHL warrants urgent referral to otolaryngology and 84.6% (n = 44) reported that unilateral sudden-onset hearing loss warrants urgent referral for audiological testing. 73.1% of participants (n = 38) reported that they would attempt to differentiate between conductive and sensorineural hearing loss if presented with unilateral, acute or sudden-onset hearing loss. 61.5% (n = 32) would rely on tuning fork tests to inform management decisions, as compared to 94.2% (n = 49) relying on case history and 88.5% (n = 46) on otoscopy. 76.9% (n = 40) would prescribe corticosteroids if presented with confirmed, unilateral SSNHL.

Conclusion: The majority of family physicians in the study would make appropriate referral and treatment decisions in the management of SSNHL, understanding it is a medical emergency. Tuning fork tests are under-utilized for informing management decisions compared to other means of differentiating conductive and sensorineural hearing loss. Further research is needed to understand why some family physicians do not prescribe corticosteroids for treatment of SSNHL, which may then identify any gaps in knowledge or inform improvements in clinical protocol.

Keywords: Rinne test; Tuning fork; Weber test; sudden hearing loss; sudden sensorineural hearing loss.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Participant responses that may explain their usage of tuning fork tests in the evaluation of unilateral, sudden-onset hearing loss
Fig. 2
Fig. 2
Participant responses indicating the various means utilized for informing management decisions regarding unilateral, sudden-onset hearing loss
Fig. 3
Fig. 3
Responses that reflect participants’ understanding of sudden sensorineural hearing loss as a medical emergency
Fig. 4
Fig. 4
Responses reflecting participants’ knowledge and practices pertaining to the treatment of unilateral, sudden sensorineural hearing loss
See this image and copyright information in PMC

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