Pathophysiologic phenotyping of idiopathic sudden sensorineural hearing loss: toward precision management

Idiopathic sudden sensorineural hearing loss (ISSNHL) is traditionally managed as a uniform clinical emergency using empirical corticosteroid protocols, yet outcomes vary widely, suggesting underlying etiologic heterogeneity. This review aims to propose a precision medicine framework for ISSNHL by re-examining the condition through specific pathophysiologic determinants, including structural third window syndromes,...

This conceptual framework for phenotyping idiopathic sudden SNHL is promising but not yet validated in clinical trials; audiologists and ENT clinicians should follow emerging guidelines rather than changing corticosteroid protocols now, but awareness of precision-medicine approaches is warranted.

Shifting idiopathic sudden SNHL management from one-size-fits-all corticosteroids toward biologically informed precision treatment could meaningfully improve recovery rates in a condition where outcomes remain inconsistent.

1. 01Idiopathic sudden SNHL is currently treated empirically with corticosteroids regardless of underlying cause.
2. 02Authors propose classifying patients by pathophysiologic subtype (e.g., vascular, viral, autoimmune) to guide targeted therapy.
3. 03Precision management could reduce unnecessary steroid exposure and improve treatment matching.
4. 04The framework is conceptual and requires prospective validation before clinical adoption.
5. 05Published in a peer-reviewed ENT/otolaryngology journal, lending credibility to the proposal.

PMID

42120571

DOI

10.1007/s00405-026-10285-x.

Journal

European Archives of Oto-Rhino-Laryngology

Publication type

review

Evidence level

5

Population

Patients with idiopathic sudden sensorineural hearing loss

Intervention

Pathophysiologic phenotyping to guide precision management of idiopathic sudden SNHL

Comparator

Uniform empirical corticosteroid treatment