I realized that it was over two years since I wrote an article on sudden hearing loss. I thought that the message was worth repeating since the fact that a sudden hearing loss is a medical emergency is not common knowledge. I did not know this before I went to college for audiology.
It is true that a sudden hearing loss can be caused by something simple as ceumen(wax) or middle ear fluid(with or without an ear infection). Both of these can actually cause hearing loss to occur quiet suddenly. Both of these are treatable and hearing will likely return. It is sudden, sensorineural(inner ear) hearing loss that must be treated with urgency. Since it is impossible to tell, without a physician looking in your ear, whether it is simply wax or fluid, all sudden hearing loss should be treated as an emergency.
Early diagnosis and treatment, ideally within 24-48 hours, will lead to the best chance of recovery. Sensorineural hearing loss that is gradual and/or permanent has no treatment, other than amplification (hearing aids or cochlear implant).
The American Hearing Research Foundation considers a sudden(sensorineural) hearing loss one that is greater than 30 decibels over three frequencies occurring over a period of 72 hours or less. Some people report that they woke up with the hearing loss. Usually one ear is affected. Tinnitus(ringing or buzzing) often occurs with sudden hearing loss. Vertigo(dizziness) also is sometimes experienced. Patients, and sometimes physicians, assume that the hearing difficulty is due to a cold or sinus difficulty and treatment is, unfortunately, delayed.
Some causes of sudden hearing loss include infections(bacterial or viral), circulatory/vascular problems, inner ear difficulties such as Meniere’s disease, trauma, acoustic neuroma, auto immune or toxic causes, such as from ototoxic medications. Most often the cause of sudden hearing loss is unknown. Diagnosis involves obtaining a case history, physician examination, audiological evaluation and possibly other tests such as blood tests or an MRI.
The most common treatment for sensorineural, sudden hearing loss is corticosteroids(pills). When treatment is within 10 days of onset, recovery of hearing is experienced about 50% of the time. After 14 days, recovery is rarely achieved, especially with a severe hearing loss. This is why this must be treated as an emergency. Once hearing tests determine that hearing is stable, then further audiological recommendations can be made. If there is partial, or no, recovery, a hearing aid may be appropriate.
If you or a loved one experiences sudden hearing loss in one or both ears, call an ear, nose and throat physician(ENT) or an audiologist as soon as possible. Since the ENT will likely refer you to an audiologist for testing, calling an audiologist first may actually save time. Make sure you tell the office that the hearing loss is sudden so that they will get you in the next day or so. If they don’t, then call someone else. The audiologist will also be able to rule out the simple causes of sudden hearing loss, such as wax or fluid. You will still likely need to see an ENT for treatment, but there will just be less urgency. Results can then be shared with the physician quickly so treatment can begin quickly.
Lori Biasotti, Au.D., is a NY State Licensed Audiologist with a private audiology/hearing aid dispensing practice called Family Hearing Center at 18 Westage Business Center Drive in Fishkill, NY(near Charlie Brown’s Restaurant). For more information on hearing and the office visit www.familyhearing.org or call (845)897-3059 with questions or to make an appointment.