While I will ply you with a lot of information about sudden deafness, or as it is also called, sudden sensorineural hearing loss (SSNHL), I want you to remember the most important piece of information…AS SOON AS you notice it, get to an otolaryngologist as soon as possible!
What is sudden deafness?
As the name implies, sudden sensorineural hearing loss, for the most part, is just that. Nine out of 10 people lose hearing in one ear.and can happen suddenly, or over 72 hours or less. You may still hear some sounds out of the affected ear, but they’ll be softer. Some people first notice hearing loss when they try to talk on the phone with the affected ear. Others hear a loud “pop” right before their hearing goes away.
Ear pressure or fullness and/or tinnitus in the affected ear are typically the first signs of sudden hearing loss. SSHL can vary in severity, and in worst case scenarios, permanent hearing loss is possible.
Common symptoms of SSHL can include: no recognizable cause of hearing loss, no ear pain accompanying the sudden loss, and the loss only occurring in one ear. While ear pressure and tinnitus have already been mentioned, dizziness or vertigo and loss of sensation, or numbness of the outer ear can also occur.
What causes sudden deafness?
There are various ear disorders that can bring about SSNL, but only about 10 percent of people diagnosed with SSHL have an identifiable cause. Conditions such as infections, head trauma, autoimmune disease, medications that treat cancer or severe infections, neurological disorders, circulatory disorders, and disorders of the inner ear, such as Meniere’s Disease.
Many of the causes listed above are accompanied by other medical conditions or symptoms that can direct us to a valid diagnosis. We know that circulation in the inner ear is reduced during sudden hearing loss. Therefore, there is a theory that stress can cause SSHL. A chaotic environment or severe timelines at work or home could lead to circulatory disorders, potentially leading to sudden hearing loss.
While SSHL usually occurs in one ear, disorders such as autoimmune disease can affect both ears. And, when single sided SSHL occurs, tumors on the auditory nerve should be ruled out as the cause
Other possible causes of sudden hearing loss include:
- Viral infections or reactivations (e.g. herpes or chickenpox)
- Arteriosclerosis and subsequent circulatory disorders
- Metabolic disorders, such as diabetes or high cholesterol
- A ruptured oval or round window
- Cervical spine injury (e.g. whiplash)
- Elevated platelet aggregation (blood clots)
- Occlusion (thrombosis) of the inner ear’s vessels
- Autoimmune diseases
- Previous acute otitis media (middle ear infection)
How is sudden deafness diagnosed?
If you experience symptoms of SSHL, your doctor should rule out conductive hearing loss—hearing loss occurring in the outer or middle ear, such as ear wax, swimmer’s ear, or middle ear infection.. For sudden deafness without an obvious, identifiable cause upon examination, your doctor should perform a test called pure tone audiometry as soon as possible of onset of symptoms to identify any sensorineural hearing loss.
Process of elimination is mostly used to obtain a diagnosis of SSHL. Along with the comprehensive audiometry, immittance testing, and oto-acoustic emissions testing, exams such as blood pressure measurement, blood tests, otoscopy, ultrasound, balance testing, and MRIs are all performed to obtain the best diagnosis.
How is sudden deafness treated?
When the cause of SSNL is not known, the most common treatment is corticosteroids. Steroids can treat many disorders and usually work by reducing inflammation, decreasing swelling, and helping the body fight illness. For SSHL, physicians perform direct intratympanic injection of steroids into the middle ear; the medication then flows into the inner ear. The injections are usually performed in-office, by otolaryngologists, and are an option for people who cannot take oral steroids or want to avoid their side effects.
Steroids should be used AS SOON AS POSSIBLE for the best effect and may even be recommended before all test results come back. Most of those who received prompt treatment can recover some or all of their hearing. Delayed treatment, (more than two to four weeks) will decrease your chances of reversing or reducing permanent hearing loss.
Once you have had SSHL, your physician may want to look at what risk factors can be mitigated, such as high blood pressure, obesity, high cholesterol, stress, and diabetes, to name a few.
In a nutshell, treatment for SSHL requires enhancement of inner ear circulation and addressing the risk factors mentioned. Other forms of treatment include:
- Circulation can be improved with circulation-enhancing medication, which can also include cortisone to prevent any swelling.
- Local anesthetics can treat SSHL by blocking nerves that can cause vascular constriction.
I know that there is A LOT of information in this blog, and some of it sounds scary. Just know this… if you believe you are experiencing sudden sensorineural hearing loss, reach out immediately, to an otolaryngologist, family physician, or audiologist. There may be another cause for the sudden loss, but the sooner treatment takes place, the better the outcomes.