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Abstract：
BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss.
OBJECTIVE: To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.
OBJECTIVE: To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.
摘要：
背景：特发性突发性感觉神经性听力损失（ISSNHL）是一种突然的，无法解释的单方面听力损失。
目的：更新西班牙关于诊断的共识，ISSNHL的治疗和随访。
方法：在对1966年至2018年3月的文献进行系统回顾之后，以MESH术语“（急性或突然）听力损失或耳聋”，进行了第三次更新，包括1508篇相关论文。
结果：关于诊断，11ISSNHL临床怀疑，以下诊断测试是强制性的：耳镜检查，针法,音调测听,言语测听,和鼓室测压,低估导电原因。在建立临床诊断后，在治疗开始之前，应该进行全面分析。然后应该要求MRI，理想情况下在诊断后的前15天进行，以减少特定的原因，并帮助了解每种情况下的病理生理学机制。虽然治疗非常有争议，由于其对ISSNHL后生活质量的影响以及与短期类固醇治疗相关的少数罕见不良反应，这种共识建议所有患者都应该接受类固醇治疗，口服和/或鼓室内，取决于每个病人。如果全身性类固醇失败，鼓室内抢救也建议。随访应在第7天和12个月后进行。
结论：经协商一致，治疗后的结果应报告为纯音调测听中绝对分贝的恢复和言语测听的改善。
目的：更新西班牙关于诊断的共识，ISSNHL的治疗和随访。
方法：在对1966年至2018年3月的文献进行系统回顾之后，以MESH术语“（急性或突然）听力损失或耳聋”，进行了第三次更新，包括1508篇相关论文。
结果：关于诊断，11ISSNHL临床怀疑，以下诊断测试是强制性的：耳镜检查，针法,音调测听,言语测听,和鼓室测压,低估导电原因。在建立临床诊断后，在治疗开始之前，应该进行全面分析。然后应该要求MRI，理想情况下在诊断后的前15天进行，以减少特定的原因，并帮助了解每种情况下的病理生理学机制。虽然治疗非常有争议，由于其对ISSNHL后生活质量的影响以及与短期类固醇治疗相关的少数罕见不良反应，这种共识建议所有患者都应该接受类固醇治疗，口服和/或鼓室内，取决于每个病人。如果全身性类固醇失败，鼓室内抢救也建议。随访应在第7天和12个月后进行。
结论：经协商一致，治疗后的结果应报告为纯音调测听中绝对分贝的恢复和言语测听的改善。
