Sudden Hearing Loss - What causes it, and what you should know

Sudden Hearing Loss - What causes it, and what you should know

Sudden hearing loss is a serious condition that needs immediate medical attention. As the name suggests, there is typically no warning, nor is there any way to predict who is at risk. Sudden hearing loss affects about 4000 new cases per year in the United States. It can affect one or both ears. Tinnitus and a feeling of fullness in the ear(s) often accompany the hearing loss.

In all cases, each patient needs to be seen by both an Audiologist and an ENT/Otologist. After taking a history and looking in the patient’s ears to assure that there is no wax causing the problem; a battery of audiometric tests is performed. The purpose of the testing is to determine the degree of the hearing loss and also to determine whether the sudden loss is due to malfunction of the hearing nerve or a problem in the middle ear. Hearing loss due to a problem in the hearing nerve or cochlea is called “sensorineural” and a loss that is caused by a problem in the middle ear is called “conductive.” You can also have a combination of the two, which is called a “mixed loss”. Different medical treatments are used for each of these types of hearing loss.


After the hearing testing is completed, and it is determined that the patient has sensorineural hearing loss, the patient is seen by the Physician for assessment and a treatment plan. Treatment often involves steroids, either taken orally or via an injection through the eardrum or both. This treatment is often repeated. During that time, it is important to have serial audiograms to follow any possible changes in hearing thresholds and/or speech discrimination ability.

What is the cause of sudden sensorineural hearing loss (SSNHL)?

It can be caused by many things including: wax in the ear canal, systemic infections, diseases of the ear, ototoxic medications, trauma to the head, cardiovascular disease, stroke, or a tumor on the hearing nerve. In most cases of SSNHL the cause cannot be determined. When the cause is known, the problem may not solely be due to a problem in the inner ear. This is why thorough testing must be done to determine appropriate treatment. The doctor may order additional testing which could include MRI, CT Scan and lab work.

Over 50% of SSNHL cases cannot be linked to a cause. These cases, called “Idiopathic Sudden Sensorineural Hearing Loss” are attributed to effects of unknown viral, vascular, or immunological disturbances.

It is not possible to predict recovery time or degree of recovery. If recovery does not occur, despite immediate and appropriate treatment, the patient may be able to benefit from amplification. Hearing aid(s) may be considered at that time, with the caution that acclimatization to amplification through the injured ear is a slow, unpredictable, and a highly individual process.

What you should know:

Prompt and accurate diagnosis and immediate appropriate treatment is imperative. Too often a patient waits or is treated for an ear infection. This can lose valuable time. The potential for hearing improvement is best achieved if the patient is treated appropriately within 72 hours of the sudden hearing loss.

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