Abstract
Sudden idiopathic sensori‐neural hearing loss is more common than generally recognized. Hearing recovers spontaneously within a few hours or days, and the loss is not recognized as cochlear in origin but is blamed on eustachian tube obstruction, because the symptoms can be identical; thus, a large proportion of patients are treated by physicians with decongestants and middle ear inflation, without obtaining audiograms. In an already damaged cochlea, middle ear inflation and other unwarranted procedures, including over enthusiastic audiometry, can lead to further injury. In general, prognosis for recovery from sudden hearing loss correlates best with the interval between symptom onset and the first audiogram, and very poorly with either the type of treatment or the interval between symptoms and the patient's first visit to a physician.

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