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ENT — UKMLA MCQ

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HardENTUKMLAMRCGP AKTMRCEM SBAMRCP Part 1

A 45-year-old wakes with unilateral sensorineural hearing loss and tinnitus that developed over several hours yesterday. Otoscopy is normal and there are no focal neurological signs. What is the immediate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Refer immediately for ENT assessment within 24 hours and consider corticosteroids

The best answer is “Refer immediately for ENT assessment within 24 hours and consider corticosteroids”. Sudden hearing loss over 3 days or less within the previous 30 days, unexplained by external or middle-ear disease, requires immediate referral for assessment within 24 hours. Idiopathic sudden sensorineural hearing loss may be treated with corticosteroid. Waiting for MRI or routine audiology risks losing the time-sensitive therapeutic window; tinnitus without vertigo does not make the loss benign.

Reference: NICE NG98, Hearing loss in adults: sudden hearing loss: https://www.nice.org.uk/guidance/ng98/chapter/recommendations