autoimmune inner ear disease. With sudden hearing loss as a symptom, a disease process could involve any of these theoretical possibilities. Each theory may explain a number of episodes of SSNHL.
TABLE 160.1 DIFFERENTIAL DIAGNOSIS IN SUDDEN SENSORINEURAL HEARING LOSS
been postulated to produce hearing loss by creating a state of relative endolymphatic hydrops or by producing intracochlear membrane breaks. Rupture of intracochlear membranes would allow mixing of perilymph and endolymph, effectively altering the endocochlear potential. Simmons (27) favored the theory of intracochlear membrane rupture, as did Goodhill and Harris (28); histologic evidence was documented by Gussen (29).