What is the recommended initial management for a patient diagnosed with sudden sensorineural hearing loss in a primary care setting?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For a patient diagnosed with sudden sensorineural hearing loss in a primary care setting, the initial management focuses on timely referral based on the onset of hearing loss .

  • If the hearing loss developed suddenly (over a period of 3 days or less) within the past 30 days, refer immediately to an ear, nose and throat (ENT) service or an emergency department, to be seen within 24 hours .
  • If the hearing loss developed suddenly more than 30 days ago, refer urgently (to be seen within 2 weeks) to an ENT or audiovestibular medicine service .
  • If the hearing loss worsened rapidly (over a period of 4 to 90 days), refer urgently (to be seen within 2 weeks) to an ENT or audiovestibular medicine service .

Additionally, a steroid can be considered to treat idiopathic sudden sensorineural hearing loss in adults .

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