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Chapter 4
Primary Care Otolaryngology
Complications of Acute Otitis Media
Meningitis, sigmoid sinus thrombosis, subperiosteal abscess of the mastoid,
brain abscess, and facial nerve paralysis. See Chapter 5, Otitis Media.
Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss (SSHL) is an idiopathic, unilateral, sen-
sorineural hearing loss with onset over a period of less than 72 hours. The
most common theories for the etiology are a viral infection or a disorder
of inner ear circulation due to vascular disease. A wide variety of treat-
ments have been used to treat SSHL, including oral and intratympanic
steroids, hemodilutional agents, anticoagulants, antivirals, hyperbaric oxy-
gen, and vitamins. The most common treatment for SSHL is a tapered
course of oral corticosteroids and/or intratympanic corticosteroid injec-
tions, yet there is no clear-cut evidence that shows a significant treatment
effect. Regardless, SSHL is a medical emergency that warrants urgent con-
sultation and follow-up with an otolaryngologist. The prognosis is variable
and depends on the patient’s age, initial severity of the hearing loss, and
promptness of medical treatment.