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Sudden Hearing Loss: A Medical Emergency

What is sudden sensorineural hearing loss?

Sudden sensorineural hearing loss (SSNHL) is a rapid loss of hearing that occurs overnight, or over a period of up to three days. Usually, only one ear is affected. Patients may experience a feeling of fullness in the ear and tinnitus (or ringing of the involved ear). They may also feel vertigo, or imbalance, which generally improves over a few days.

Many people notice the sudden loss when they wake up in the morning.  Others are unaware of the hearing problem, until they pick up the telephone.  Their first thought is that the telephone is dead, until they move the phone to their other ear, and then realize that the first ear isn’t working.

Sudden hearing loss is a medical emergency, because treatment must be initiated immediately if the hearing is to be saved.

Causes

There are over 100 different causes of SSNHL. However, an exact cause is only identified in a minority (less than 10%) of patients. The list of causes includes: infection, trauma, tumors, Meniere’s disease, medication, and circulatory disorders that decrease oxygen flow to the inner ear.

Treatment – Timing is Critical!

Anyone experiencing SSNHL should see a physician, preferably an ear specialist (otologist or otolaryngologist), as soon as possible.

Why? If the hearing loss is sensorineural, it is possible to save the hearing, but only if proper treatment is begun immediately. Treatment with oral steroids is the gold standard. Steroid administration directly to the inner ear has been shown to rescue hearing loss when oral steroids fail. It is important to realize that this treatment must be initiated within 1 to 4 weeks after the onset of the hearing loss. Beyond 4 weeks, the hearing loss will likely become a permanent disability.

Unfortunately, many patients do not see a specialist soon enough. There are several factors that may account for the delay. Sometimes, patients mistakenly think they simply have wax in their ears. On other occasions, physicians unknowingly contribute to the delay. Patients are often prescribed decongestants and allergy pills, which do not treat the hearing loss, and only serve to delay referral to the specialist.

What to do if you experience sudden hearing loss:

Be sure to see a specialist as soon as possible. If your insurance carrier allows, make an appointment with the otologist or otolaryngologist directly. Only an otologist has the ability to treat with steroid directly to the inner ear. A comprehensive medical evaluation and audiogram will be performed. This will ensure that the loss is nerve related, and not due to fluid, wax, infection, or a tumor. An MRI scan of the brain and ear will also be ordered to exclude the presence of a tumor.

Conclusion

The effects of sudden hearing loss can be devastating —and can become a permanent disability if not treated promptly.  Both patients and physicians need to be aware of the possibility of SSNHL and the urgency of proper diagnosis and treatment.

Dr. Kato is the founder of The Ear Institute in Palm Desert. Her top priority is improving the quality of life of her patients. Dr. Kato can be reached at: 760-565-3900.

Sources: 1) Gulya, A. Julianna: Sudden sensorineural hearing loss: an otologic emergency; 2) Comprehensive Therapy 1996; 22(4):217-221; 3) Hughes, Gordon B. et. al.: Sudden sensorineural hearing loss. Otolaryngology clinics of North America 1996; 29:393-405; 4) National Institute on Deafness and other Communication Disorders

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