Research Gaps - Sudden Hearing Loss (SHL)
The Clinical Practice Guideline: Sudden Hearing Loss was developed based on the current body of evidence regarding the diagnosis, treatment, and ongoing management of patients with SHL. As determined by the guideline panel's review of the literature, assessment of current clinical practices, and determination of evidence gaps, research needs were determined as follows:
- Determine a standardized and evidence-based definition of SSNHL (sudden sensorineural hearing loss).
- Investigate the effectiveness of corticosteroid treatment vs a placebo. The panel believes that such a clinical trial should be conducted due to the equipoise of existing data.
- Further investigate the benefit of HBOT (hyperbaric oxygen therapy). Current evidence regarding this treatment option looks promising; however, there is a bias among US physicians and payers not to offer this therapy. Standardized treatment protocols are needed for HBOT for ISSNHL (idiopathic sudden sensorineural hearing loss).
- Develop standardized outcome criteria to aid the comparison of clinical studies.
- Further study the use of IT steroids as salvage therapy, particularly the optimal drugs, dosage, concentrations, and administration schedules for IT therapy.
- Develop criteria to determine at what level of hearing recovery IT steroids would be offered as salvage.
- Determine the percentage of patients who gain serviceable hearing as a result of treatment.
- Investigate the use of "combined therapy" (ie, oral and IT steroids) in patients with ISSNHL.
- Develop long-term follow-up protocols for patients with ISSNHL.
- Evaluate therapies using standardized definitions and treatment protocols across studies.