**6. Medical history and physical examination**

Medical history is typical in SHL. Patients usually notice in the morning, during a telephone conversation, after exiting a noisy environment that their hearing sense is suddenly disappeared and generally they visit panicked the nearest physician with a fear of being deaf. In sudden hearing loss, as patients consult immediately a physician, early diagnosis and treatment are possible. During the physical examination, as no SHL-specific finding can be detected during the bilateral otomicroscopic examination, otoscopic examination is usually normal. In some cases, there can be an obstructive ear plug, which may be removed with difficulty. At the same time, in patients with otological disorders like chronic otitis media and tympanic membrane retraction, previous audiometry reports might be needed for the diagnosis and especially in patients with presbyacusis and missing audiometry reports, diagnosing is relatively difficult. In such cases, we have to depend only on the anamnesis. In the anamnesis, the important points are the presence of tinnitus and ringing, the presence of concomitant vertigo, and presence of a similar event in the past. Questioning of these aspects will provide useful information regarding the differential diagnosis. The patients should also be evaluated for the known chronic diseases and used medication. Especially autoimmune disorders, coagulation disorders, cardiovascular diseases, previous infectious diseases, and trauma should be questioned. Following the physical examination, hearing examination (Weber, Rinne) should be carried out in order to evaluate the type and severity of the hearing loss. Afterwards, the diagnosis should be confirmed with pure-tone audiometry.
