Sudden hearing loss is a medical emergency: What patients need to know

by Selena E. Briggs, MD, Otologist, Neurotologist and Skull Base Surgeon
May 1, 2018

Every year in the U.S., one in 5,000 people experience sudden sensorineural hearing loss, or sudden hearing loss. This is considered a medical emergency, but one of the most common causes is something that appears seemingly harmless: upper respiratory tract infections. In fact, one in four patients with sudden hearing loss had an upper respiratory infection within a month before the hearing loss. Of the identifiable causes of sudden hearing loss, the vast majority are due to viruses, such as upper respiratory tract infections.

Unfortunately, there’s no preventative therapy that has been identified to reduce the risk. The window of treatment is typically 21 days for therapy to be most effective. Outside of that time frame, the likelihood of permanent hearing loss is significantly greater. According to most studies, 32 to 65 percent of individuals with sudden hearing loss with experience some degree of recovery. Normal hearing will return for just 33 percent of these people. For another third, hearing will improve somewhat. For the final third, the hearing loss will be permanent. The difference in hearing restoration is in how quickly a patient receives specialized care.

LISTEN: Dr. Briggs discusses sudden hearing loss in the Medical Intel podcast.

What is sudden sensorineural hearing loss?

While an acute sinus infection or ear infection can cause pressure, a muffled sensation or fluid in both ears, sudden sensorineural hearing loss usually occurs in just one ear. It can happen immediately—people often wake up with it—or it can develop over several days.

Sudden hearing loss isn’t a pressure problem, either. It actually causes injury to the nerve in your ear. Oftentimes, individuals who have sudden sensorineural hearing loss experience other symptoms, such as ringing in the ears, vertigo, dizziness, or a high pitched or white noise sound in the ear. These symptoms can be further indicators of damage to the nerve in your ear.

What should you do if you experience sudden hearing loss?

The first thing to do is to see your primary care doctor or go to a nearby urgent care center for an ear exam. It seems odd, but an ear exam that comes back normal in this situation is an emergency. The doctor will examine your ear to make sure your eardrum looks normal, that wax isn’t plugging up the ear canal, and that you have no fluid behind the eardrum. If you have sudden hearing loss and a normal ear exam, you need to have a hearing test from a specialist right away.

How can a specialist help?

Once a patient is diagnosed with sudden sensorineural hearing loss, they should be seen by an otolaryngologist/neurotologist within 24 to 48 hours. The specialized treatment is started rather urgently because it offers the best chance for the best outcome.

We’ll start with a physical examination and take a medical history. We often order an MRI of the brain and inner ear to evaluate any changes or compression of the nerve responsible for hearing and balance. Based on your personal and family medical history, we also may order laboratory tests to assess for diabetes, other autoimmune disorders or infections.

Treatment will depend on your existing conditions. For example, if you have diabetes or hypertension, we will tailor therapies to accommodate those conditions. Your doctor may recommend oral steroids or injection steroids in the middle ear space, or a combination of the two. Steroid treatments decrease inflammation on the nerve to increase blood flow, which improves hearing. Another recommended therapy is hyperbaric oxygen therapy. In this treatment, you’re put into a chamber that simulates scuba diving. In the chamber, we’ll boost the oxygen level in your system in the hope that it’ll help it to heal your nerve faster.

Not all sudden changes in your hearing are virus related. A loud sound or a blast can cause a sudden hearing loss, and it’s treated in a similar way. Sudden hearing loss also can be an early sign of a stroke, tumor on the skull base, thyroid disorder, autoimmune disorder, or diabetes. Many diseases can cause sudden hearing loss, which is why it’s so important for you to see a doctor right away.

For example, I treated a patient who also was a doctor for bilateral hearing loss, meaning it was occurring in both ears. This individual needed his hearing to perform his work. Fortunately, he came to see me almost immediately after he noticed the hearing loss, which was profound. At his first visit, we had to communicate by typing on a computer because he couldn’t hear at all. We started oral steroids, inner ear steroids, and hyperbaric oxygen therapy. Remarkably, his hearing was fully restored.

Sudden hearing loss can be a frightening and emotional experience. Many of us take our hearing for granted, and once we lose it, we realize how important it is. Seeking treatment right away can lead to more positive outcomes.

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Category: Healthy Living, Medical Intel     Tags: #ENTdeafnessear-infectioneardrumsudden hearing loss