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Sudden sensorineural hearing loss (SSNHL) is a term to describe a dramatic decline in hearing over a period of hours or days. The usual outcome is little or no recovery or further decline in hearing. Some presentations are due to an acoustic neuroma, trauma, infection, autoimmune disease affecting the inner ear or circulatory disorders resulting in an inner ear stroke, but in most cases no specific underlying cause can be found. Several treatments have been proposed such as steroids, infusions of dextran and heparin, carbogen inhalations, histamines, calcium channel blockers and several antiviral agents have all been tried, but no treatment has resulted in a consistent recovery of the lost hearing. In a Taiwan study of 66 patients, researchers found a somewhat greater chance of recovery in the zinc supplemented patients. However, the sample size is too small to make firm recommendations about general treatment of SSNHL patients. Further investigation with a larger trial will need to be conducted. This may involve several centres simultaneously gathering a more substantial volume of data. In Australia, the current recommendation for SSNHL is to regard it as a medical emergency and seek urgent medical attention. The initial treatment would be a course of high dose oral steroid for a period of 10 days. If there is no recovery, as is often the case, a dose of steroid injected into the middle ear through the ear drum should be considered. Further investigation in the form of a blood test, thyroid and immune function test and a MRI of the inner ear should be carried out in time. Long term follow up will be required to manage the residual hearing loss with a hearing aid or in the case of bilateral SSNHL, a cochlear implant. 

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