Predictors of Delays in the Management of Idiopathic Sudden Sensorineural Hearing Loss

Objective: To study predictors of delayed presentation, diagnosis, and treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective medical chart review and patient telephone survey. Setting: Tertiary medical center. Subjects and Methods: All patients who initially presented or referred with unilateral ISSNHL between 2016 and 2020 were included. Associations between epidemiological, demographic, and socioeconomic profiles and delays in presentation, diagnosis and treatment were studied. Results: A total of 518 patients were suitable for study inclusion. The total delay in the emergency department (ED) setup was a median (interquartile range, IQR) of 1 (0–1) day, 7 (6–12) days in a community otolaryngologist setup, and 15 (8–25) days in a general practitioner setup. Patients who presented to the ED first also had fewer diagnostic and treatment delays. Those who presented to a community otolaryngologist first had significantly longer presentation delay (5 [4–8] days p < 0.001) and significantly longer treatment delays (1 [1–3] days p < 0.001). Patients who presented to a general practitioner first had significantly longer presentation delays compared with ED presentation, and the longest diagnostic and treatment delays (3 [2–5], 8 [4–12] days, and 4 [2–7] days, p = < 0.01, p = <0.01, and p < 0.001, respectively). There was no association between socioeconomic status or demography and presentation, diagnostic, or treatment delays. Conclusion: Total delay in ISSNHL management is affected by the venue of the first medical encounter. General practitioners' level of awareness of the need for empiric steroidal treatment of ISSNHL without delay should be raised. Level of Evidence: 3 Laryngoscope, 2024.