Sudden sensorineural hearing loss (SSNHL)

Over the last ten years, I have seen an increasing number of these patients, and they are getting younger with a recent one aged 17. The dx is always a guess and so imaging or ear signs, and the hsp70 ABS were useless. I treat with methotrexate : mostly successful (well I think) and then rituximab on 2 occasions The earlier one starts mtx the more likely is to work , Being deaf in one ear is a bad prognostic sign The ENT community split as many just wait till person deaf and put cochlear implant in, though to me that’s silly. In addition if they also have vertigo they have major issues. Daman