Some reports maintain that a cold or other upper respiratory illness preceded the onset of SSNHL in as many as 40 percent of cases. Unfortunately, these reports lack corresponding data on the comparative frequency of upper respiratory illness in a matched control population. What about the evidence of blood examinations? In response to a virus, the immune system produces a temporary increase in the level of antibodies against the speciﬁc virus, and many case reports on patients with SSNHL show that they experience a brief, sharp rise in antibody levels against common viruses such as herpes, ﬂu, mumps, or rubella.
Depending on timing, intra-tympanic steroid injection is also offered (dexamethasone 10-24mg/cc). Intra-typmpanic steroid injection is performed by inserting a needle through the eardrum and injecting about of highly concentrated steroids directly into the middle ear space. The patient is than instructed to keep the affected ear up for 30 minutes without swallowing, yawning, or popping the ear. After injection, the patient is allowed to immediately resume normal activities. This steroid injection has also been used to treat Meniere's Disease flare-ups.
The dura mater and the mastoid or craniotomy are then closed with a variety of materials, and the patient is observed in the intensive care unit. Because the balance fibers are cut suddenly, the surgery causes intense vertigo and imbalance for a few days requiring supportive medical care, medications for nausea and eventually physical therapy. A cane or walker may be needed for a while, depending on the patient’s health and activity level prior to the surgery. Once the patient is able to ambulate safely, he may be discharged home, but vestibular and balance therapy is continued on an out-patient basis to speed the patient’s recovery as much as possible. A return to full function occurs in most patients, although many do feel imbalanced when tired or stressed.