QuestionSBA
QuestionChoice
NICE states that any adult experiencing a sudden-onset sensorineural hearing loss (SSNHL) manifesting over 3 days or less should be immediately (less than 24 hours) referred to ENT or the emergency department. This is because SSNHL carries a major risk of progressing to permanent deafness without prompt expert intervention. ENT typically treat with oral corticosteroids but these should not be prescribed in general practice for SSNHL.
10000306
a
Immediate referral to ENT
QuestionChoice
Due to the risk of permanent hearing loss if left untreated, SSNHL warrants an immediate referral (less than 24 hours). A routine referral is therefore incorrect due to the increased risk of permanent disability.
10000310
e
Routine referral to ENT
QuestionChoice
Although oral corticosteroids form the basis of treatment for SSNHL, the setting is important in this question. In general practice, all cases of SSNHL should be urgently referred to the nearest emergency department or ENT department. SSNHL should only be treated by hospital specialists.
10000307
b
Prescribe an oral corticosteroid
QuestionChoice
ENT may decide to perform audiology testing but a referral should be made to them first. Audiology testing should not be arranged by general practice in the case of SSNHL.
10000309
d
Arrange outpatient audiology testing
QuestionChoice
This is incorrect. NSAIDs have no place in the management of SSNHL. In general practice, an immediate referral to ENT or ED should be made where the patient is likely to be managed with oral corticosteroids.
10000308
c
Prescribe a non-steroidal anti-inflammatory
Concept
Chapter
2693
3739
Sensorineural Hearing Loss
Topic
139
Ear, Nose, and Throat
12608
A 24-year-old female presents to General Practice after experiencing sudden onset hearing loss in her left ear over the last 24 hours. On examination, Rinne's test is positive in both ears and Weber's test lateralizes to the right side. Otoscopy is unremarkable. She has never experienced anything like this before and has no relevant past medical or family history.

Which of the following is the most appropriate next step?
a