Alberta Health Services
Otology & Neurotology Sudden Sensorineural Hearing Loss (SSNHL) Program

Now accepting direct referrals from audiologists

Sudden hearing loss is an emergency. A faster referral pathway is here.

If your audiogram confirms sudden sensorineural hearing loss, you can now refer the patient straight to the SSNHL Program — no physician referral needed. Early steroid treatment gives the best chance of recovery, so every day counts.

SSNHL Referral Form (PDF) Fax 403-592-4289

How to refer

  1. Confirm on audiogram

    Sensorineural decline of more than 30 dB at 3 or more consecutive frequencies.

  2. Complete the form

    Fill in the SSNHL Referral Form and attach the recent audiogram.

  3. Fax it to us

    403-592-4289

    We contact the patient directly with an appointment.

Refer when

  • > 30 dB sensorineural decline at ≥ 3 consecutive frequencies
  • Onset ≤ 3 weeks — urgent
  • Onset 3 – 12 weeks — semi-urgent

Not appropriate for this pathway

  • < 30 dB decline or < 3 consecutive frequencies
  • Onset more than 12 weeks ago
  • Conductive hearing loss

SSNHL management pathways

Sudden sensorineural hearing loss (SSNHL) management

Pathway for ED and primary care physicians

Rule out red flags

Bilateral/recurrent/fluctuating hearing loss, focal neurological symptoms, fever, gaze-evoked/downbeat nystagmus, head trauma, or barotrauma.

Patient with suspected SSNHL Sudden onset hearing loss, often unilateral, normal otologic examination, +/– vertigo/tinnitus, no evidence of otologic infection
Audiogram complete?
Yes
Confirms SSNHL? i.e. hearing loss of 30 dB or greater over at least 3 contiguous frequencies occurring within a 72-hr period
Yes
  1. Prescribe PO prednisone and start same day (1 mg/kg/d up to 60 mg/d x 10d, with 10 mg/d taper thereafter). If contraindications (uncontrolled DM, other) call ENT on call
  2. Connect Care providers can refer through Connect Care (see below). Non-Connect Care providers please see Alberta Referral Directory.
  3. Provide SSNHL patient handout (Available on Alberta Referral Directory)
No

Consider DDx; if unclear, refer to SSNHL program or call ENT on call

No
  1. Provide prescription for oral prednisone (1 mg/kg/d up to 60 mg/d x 10 with 10 mg per day taper thereafter) with instructions to fill after SSNHL confirmed by audiogram
  2. Provide patient handout on where to get audiogram (Available on Alberta Referral Directory)
  3. Provide SSNHL patient handout (Available on Alberta Referral Directory)
  4. Audiologist will make referral to SSNHL program if audiogram confirms SSNHL. No referral required in ED / primary care office.

Placing the SSNHL referral in Connect Care

Ambulatory referral to Otolaryngology – Head & Neck Surgery

  1. Open Orders and select the External Orders tab

    Connect Care Orders tabs: Active, Signed & Held, Home Meds, Cosign, Order History, External Orders (highlighted), Manage Labs.

  2. Search “ambulatory referral to otolaryngology head and neck surgery” and click New

    Connect Care Orders search box containing “ambulatory referral to otolaryngology head and neck surgery”, next to the New button.

  3. Complete the referral details

    Connect Care referral details form with To Department, Priority and Reason highlighted.
    To Department
    Select “CGY SHC OTOLOGY NEUROTOLOGY CL”
    Priority
    Select “Urgent”
    Reason
    Select “Sudden sensorineural hearing loss”

SSNHL management flowchart for audiologists

Pathway for community and hospital audiologists

Patient with suspected SSNHL Sudden onset hearing loss, often unilateral, normal otologic examination, +/– vertigo/tinnitus, no evidence of otologic infection
Audiogram complete?
Yes
Confirms SSNHL? i.e. hearing loss of 30 dB or greater over at least 3 contiguous frequencies occurring within a 72-hr period
Yes
  1. Fax referral to SHC SSNHL Program (403-592-4289), complete referral form (Available on Alberta Referral Directory).
  2. Instruct patient to initiate steroids if previously provided prescription. Otherwise, the SSNHL program will contact the patient to provide steroid prescription.
No

Consider DDx; if unclear, refer to SSNHL program or physician care (ED/UC or primary care)

No
Complete audiogram

Then continue at “Confirms SSNHL?”