SUDDEN BILATERAL SENSORINEURAL HEARING-LOSS

Most cases of sudden sensorineural hearing loss (SHL) remain idiopathi c, and the majority are unilateral, From 1989 to 1993, 823 patients wi th sudden SHL were evaluated. Of these, 14 (1.7%) had sudden bilateral SHL. We reviewed the charts of these 14 patients to compare sudden bi lateral SHL with sudden unilateral SHL. Usually, bilateral SHL was asy mmetric, Most bilateral cases received combined steroid and vasodilato r treatment, while unilateral cases were more likely to receive only o ne of these treatments. By audiological criteria, 67% of bilateral SHL cases improved, while the improvement rate in unilateral SHL was 52%; however, this difference was not statistically significant. In bilate ral SHL patients showing improvement, both ears responded. Bilateral S HL patients were older at the onset of hearing loss, had a higher inci dence of vascular disease, and were more likely to have positive antin uclear antibody titer. Recognition of similarities and differences bet ween sudden unilateral and bilateral SHL can help in counseling patien ts.