Herrera Mayte, García Berrocal José Ramón, García Arumí Ana, Lavilla María José, Plaza Guillermo
Servicio de Otorrinolaringología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, España.
Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma, Madrid, España.
Acta Otorrinolaringol Esp (Engl Ed). 2019 Sep-Oct;70(5):290-300. doi: 10.1016/j.otorri.2018.04.010. Epub 2018 Aug 6.
Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss.
To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL.
After a systematic review of the literature from 1966 to March 2018, on MESH terms «(acute or sudden) hearing loss or deafness», a third update was performed, including 1508 relevant papers.
Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and the few rare adverse effects associated with short-term steroid treatment, this consensus recommends that all patients should be treated with steroids, orally and/or intratympanically, depending on each patient. In the event of failure of systemic steroids, intratympanic rescue is also recommended. Follow-up should be at day 7, and after 12 months.
By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.
特发性突发性感音神经性听力损失（ISSNHL）是一种突发的、原因不明的单侧听力损失。
更新关于ISSNHL诊断、治疗和随访的西班牙共识。
在对1966年至2018年3月的文献进行系统回顾后，以医学主题词“（急性或突发）听力损失或耳聋”进行检索，进行了第三次更新，纳入1508篇相关论文。
关于诊断，若临床怀疑为ISSNHL，以下诊断测试是必需的：耳镜检查、听敏度测试、纯音听力测试、言语听力测试和鼓室图测试，以排除传导性病因。在确立临床诊断后且开始治疗前，应进行全面分析。然后应要求进行磁共振成像（MRI），理想情况下在诊断后的前15天内进行，以排除特定病因并有助于了解每种情况的生理病理机制。尽管治疗存在很大争议，但鉴于其对ISSNHL后生活质量的影响以及短期类固醇治疗相关的罕见不良反应较少，本共识建议所有患者均应接受类固醇治疗，根据患者个体情况口服和/或鼓室内注射。若全身用类固醇治疗失败，也建议进行鼓室内补救治疗。随访应在第7天和12个月后进行。
经共识，治疗结果应以纯音听力测试中恢复的绝对分贝数以及言语听力测试中的改善情况来报告。
