Question: A 42 year old male experiences a sudden hearing loss involving his right ear. Appropriately, audiogram is obtained that shows a moderately severe sensorineural hearing loss with 82% WRS. The left ear is normal. Prednisone at high dose is prescribed for 1 week followed by a taper, during which time he reports complete return of hearing. Repeat audiogram verifies this and shows 96% WRS and normal sloping to mild hearing loss in the high frequencies. Which of the following is the appropriate next step in management?

a) Intratympanic steroid injection as his WRS is not back to 100%

b) MRI of the brain

c) Antivirals to prevent recurrence

d) Observation - due to the return in hearing, retrocochlear pathology is ruled out

[Answer will be posted with next week's new question]

Answer to last week's question, “The Bleeding Edge” (July 12, 2021)

C - Rule out pulmonary and cerebral AVMs