A patient reporting sudden hearing loss in one ear, over 72 hours or less, needs otoscopy and tuning-fork tests at first contact. A normal ear canal with Weber lateralising to the good ear points to a sensorineural loss.
Arrange formal audiometry promptly, discuss corticosteroids early since benefit is greatest when started soon, and plan MRI of the internal auditory meatus to exclude a vestibular schwannoma. Do not label it wax or eustachian tube dysfunction without looking.
- Examine the ear canal and do Weber and Rinne tests at first contact
- Arrange audiometry as soon as possible
- Discuss corticosteroid treatment early, with contraindications reviewed
- Plan MRI to exclude retrocochlear pathology
Why it matters
Delay in recognition is the commonest reason treatment starts too late.
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