Abstract
Patients with acute low-tone sensorineural hearing loss (ALSH) who came to my clinic during the past 13 years were classified into the following 3 groups: 1) a definite ALSH group, who completely satisfied the new diagnostic criteria for ALSH proposed by the Research Committee on Acute Profound Deafness, the Ministry of Health, Labour and Welfare of Japan, 2) a practical ALSH group who did not satisfy the criteria 100%, but were considered to have ALSH because of their present history and contralateral hearing, and 3) an uncertain ALSH group that could not be diagnosed as either of the other two groups. The clinical pictures of the definite ALSH group and practical ALSH group were mainly investigated, and the following diagnostic care points were obtained.1) The practical or uncertain ALSH occurs more frequently in the outpatient clinic. 2) Taking a history of mental stress in an outpatient clinic is very difficult. 3) ALSH may occur in any age group and in patients with fixed hearing loss at any frequency, and thus various types of audiogram, except for the ascending type, may be obtained in ALSH patients. 4) ALSH-like patients with dizziness should be followed as the practical ALSH. 5) Atypical Meniere's disease should be treated as the uncertain ALSH. 6) Long-term observation for more than 2 years after onset is desirable to ascertain whether there is recurrence of ALSH.
