The Urgency of Sudden Hearing Loss
Imagine if you woke up one morning and noticed that you suddenly cannot hear as well. It may be one ear or both, but suddenly things that you normally hear with ease are inaudible. You may feel like your ear is plugged or muffled, or you may not feel any pressure at all. Your first and natural reaction may be to panic, but the most important thing to remember is to stay calm. There are many reasons for sudden hearing loss, some that are temporary and others permanent, and it depends on your recent activities and health.
This experience could be a sign of sudden hearing loss. Sudden hearing loss is considered as a medical emergency in the field of audiology.
Sudden sensorineural hearing loss is when you notice a significant shift in your hearing, with no apparent reason behind it. Many times, sudden hearing loss is caused by a bacterial or viral infection and can be treated if caught in time. It is important to see an Ear Nose and Throat (ENT) physician or audiologist within the first two to three days of onset.
The audiologist will perform a full diagnostic hearing evaluation to rule out any outer or middle ear concerns and determine the extent of the sudden hearing loss. The ENT will then prescribe a steroid treatment that can sometimes help restore part or all of your hearing. Following treatment, you will revisit the audiologist to determine the effectiveness of the steroid treatment. It is very important that treatment is administered within the first two weeks following onset, otherwise the hearing loss will often be irreversible.
Vital Questions to Determine If You Need to See a Doctor Right Away
If you ever find yourself in this situation, it is important to take into consideration your listening environment over the past few days.
Were you recently exposed to several hours of very loud noise?
If you attended a loud concert, were in a big factory around heavy equipment and machines, or went hunting/to a gun range and did not wear any form of hearing protection, this sudden hearing loss could be due to noise exposure.
Exposure to loud noises over a long period of time can damage the hair cells within our inner ear. These hair cells are small fragile structures that contract in response to sound which trigger the signals that are sent to our brain to say that we heard something. When these hair cells are damaged, their physical shape changes and they no longer send consistent signals to the brain to say sound is present. This physical damage to the hair cells leads to hearing loss.
Even one instance of noise exposure over a long period of time can cause this feeling of hearing loss, making it feel sudden.
When did you notice that sound was muffled or changed?
The rule of thumb is to stay within environments that are 85 decibels or less for no longer than 8 hours. Think about a time you went to a loud concert. You may have had the greatest time listening to great music while screaming the lyrics at the top of your lungs.
As you were leaving, did you notice that everything sounded muffled? Did you have a high-pitched ringing or buzzing in either of your ears? This is because you were in such a loud environment for a long period of time, and your ears are warning you of the damage.
Although this is still serious, this is not sudden hearing loss. The good thing is that noise exposure hearing loss can sometimes be temporary and will return within a few hours to a day of being exposed. If it persists for a few days, visit an audiologist to get a hearing evaluation.
Have you had a cold or ear infection recently?
If you were not exposed to noise, another good question to ask yourself is having you recently suffered from a cold or ear infection? These both can affect our hearing by filling our middle ear with mucoid fluid causing our eardrum and middle ear bones, the ossicles, to not transfer sound to the inner ear.
Common descriptions of this include feeling like you are underwater or that your ears are plugged. If you have not been treated for this head cold/infection, seek medical attention from your primary care physician or an ENT. By resolving the cold or infection, your hearing should be restored!
Have you had an increase in stress or physical activity recently?
If neither loud noise or recent sickness apply to you, the final question you should ask yourself is have you had an increase in stress or physical activity lately? Stress and physical activity both can change the hormone balance within our body. We also have hormones within our inner ears. Therefore, any significant change in hormones can affect our ability to hear.
These all describe instances of temporary sudden hearing loss, meaning that they will resolve over time or with treatment. This is great as your hearing can return to its original state!
Another common causes of temporary hearing loss
There are other instances where you might suddenly wake up and not be hearing as well, and these can usually be resolved fairly quickly.
Impacted Ear Wax
The most common is that your outer ear canal is occluded with ear wax, also known as cerumen. Our ear canals have a thin layer of skin that has sweat and cerumen glands. These glands naturally produce cerumen and as our skin sheds, the cerumen migrates out of our ear canal.
Usually, this is how our ears stay clean and not plugged with wax. Sometimes though, our gland can overproduce cerumen and it can build up within the ear canal.
Also, if you use q-tips you can push the cerumen together, creating a hard wall that will block the ear canal completely. This build-up of wax becomes occluded, and sound cannot pass by to reach the eardrum, middle ear bones, or inner ear, causing a “sudden hearing loss”. The difference in this though, is that it is caused by the cerumen in your ear canal not a bacteria/virus to your inner ear.
This can easily be resolved by visiting an audiologist, ENT, or urgent care to have your ears cleaned. They will use water irrigation to wash out the earwax or manual curette tools to scoop it out. Once the earwax is removed, you should feel immediate relief and your hearing should be completely restored!
Common causes of permanent hearing loss
Often though, hearing loss is permanent and will not return to its original state. Long-term noise exposure like working around heavy equipment without hearing protection for many years, can cause permanent hearing loss. Age-related hearing loss, also known as presbycusis, is permanent.
Think about your body as a whole. As we age, so does our entire body because of the active lifestyles we live. This happens to our ears as well.
Throughout life, our ears are constantly exposed to noise. Our world is a very noisy place, and we cannot always predict when loud noises will be around. Therefore, as we get older hearing loss becomes more common.
Exposure to ototoxic medications can also cause permanent hearing loss. These medications commonly include antibiotics and chemotherapy/radiation. The main goal of these medications is to treat the health condition, but they often have side effects that can damage the hair cells within our inner ears. Although this is not desired, the focus of your medical treatment is to help manage and treat your chronic conditions and not prevent hearing loss.
Other medical conditions can cause permanent hearing loss including diabetes, high blood pressure, a stroke or traumatic brain injury, or heart condition. Diabetes and high blood pressure affect blood flow and oxygen levels within the blood throughout our body, including in our inner ear. This change in blood flow and oxygen can affect the health of the hair cells, causing hearing loss.
Strokes and traumatic brain injuries commonly affect the auditory processing center within our brain, not our inner ears. This still can cause hearing loss, more specifically problems with understanding what people are saying. For permanent hearing loss, it is important to have annual hearing evaluations to monitor the hearing loss and ensure it is not changing suddenly. If you have already diagnosed hearing loss and notice a significant change in your hearing, reach out to your audiologist to discuss next steps.
Get help for your hearing loss
If you have any concerns for your hearing, even if you believe it is only temporary, it is important to get evaluated by an audiologist. They can perform a full diagnostic evaluation which will include looking in your ears with our otoscope light, getting pure tone air and bone conduction hearing thresholds, and speech recognition scores. This information can give a full picture of your ears and hearing health, which can act as both a baseline of hearing and to help develop the best treatment plan.
Hopefully your shift in hearing is only temporary and can be resolved by getting an ear cleaning, treating any infections, or by giving your ears quiet time following noise exposure. If it is determined to be permanent hearing loss, finding this out can be a difficult thing to process and accept, but your audiologist will work with you every step of the way to determine what plan works best for your needs and lifestyle.