Tinnitus and hearing loss are currently quite common in clinical practice. A large percentage of these patients end up with a diagnosis of sudden deafness. Sudden onset sensorineural deafness is defined as “a sudden onset of sensorineural hearing loss of unknown origin that can occur within minutes, hours or 3 days, with a hearing loss of at least 20 dB in at least 2 connected frequencies”. This is the definition given in our 2006 “Guidelines for the Diagnosis and Treatment of Sudden Deafness”. It is based on the results of the electroaudiometry test (images, not words, so please keep the audiogram and show it to your doctor at your follow-up appointment). The diagnostic criteria for this disease in China are even stricter than in the US (the US 2012 criteria is at least 30dB of hearing loss in at least 3 connected frequencies – the national standard is less strict than the US standard). The common understanding of how this disease arises is that there is something wrong with the ear nerve. There are many reasons why something can go wrong. The most common ones are as follows.1. Obstruction of the nerve’s nutrient vessels (anterior inferior cerebellar artery). The cause of obstruction can be simply understood as similar to the cause of cerebrovascular obstruction in “stroke”, which is more common in elderly patients; 2. Nerve virus infection. It can be simply understood that a cold is a viral infection of the nose, and this disease is a viral infection of the ear nerve; 3, no idea what the cause is (there are too many such diseases in the clinic). We encounter patients with tinnitus with hearing loss in the clinic usually do at least two tests first: electrical audiometry and acoustic impedance, which can be simply understood as binaural hearing and binaural pressure. Based on the test results, we can roughly determine whether there is deafness or not, and whether it is sensorineural deafness. If it is sensorineural hearing loss there is a diagnosis of sudden deafness that meets the above definition. According to the 2012 guidelines of the American Academy of Otolaryngology, Head and Neck Surgery, another very necessary test is an inner ear MRI. The purpose of this test is simply to rule out hearing loss due to tumor compression of the nerve or hearing nerve dysfunction caused by a tumor growing on the auditory nerve. It is also simply to rule out tumors in between diagnoses of sudden deafness. In terms of treatment, the American “guidelines” support one drug, adrenocorticotropic hormone, which is commonly known as hormone (don’t talk about hormone, many clinical diseases are cured by hormone, and the side effects are not as big as imagined by the short-term application of small doses). Why? Because the end result of neurological dysfunction, regardless of the cause, is neuroinflammatory reaction and swelling, and hormones precisely inhibit this inflammatory reaction. Our 06 guidelines support the application of hormones, antiviral drugs, vasodilators, anticoagulants, neurotrophic drugs, etc. Why? Because the Chinese still prefer to treat the disease from its cause, so-called treating both the symptoms and the root cause. The treatment of this disease is usually done with 1-2 courses of drugs, the common ones used in our hospital are hormones + vasodilators + neurotrophic drugs (with the addition of antiviral drugs or hyperbaric chambers depending on the situation), each course of 14 days. If the effect obtained in the first course can be scored 90 points, the second course can only be scored 10 points, so the patient’s own will is important whether to proceed to the second course or not. How effective will it be in the end? It is simply understood that 1/3 of patients will be cured, 1/3 of patients will be better (with sequelae) and 1/3 of patients will not be well at all. Elderly patients, patients with vertigo, and patients with other underlying diseases tend to fall in the latter 1/3.