Sudden Hearing Loss Is An Emergency!
By: Dr. Lori Biasotti
A patient situation that happened recently made me realize that this message is worth repeating. She came in three weeks after losing hearing in one of her ears. Her physician tried to treat her for an ear infection, but it did not get better. It probably won’t.
Sudden hearing loss in one ear is rare, but when it happens it should be treated as a medical emergency. Many people do not know this. I didn’t know this until I went to college for Audiology.
It is true that sudden hearing loss can be caused by something as simple as cerumen(wax) or middle ear fluid. Both of these could cause hearing to be reduced sometimes suddenly and sometimes at just one ear. The type of hearing loss caused by wax or fluid is a conductive hearing loss. This type of hearing loss is usually treatable and temporary. The sudden sensorineural (inner ear) type of hearing loss is the type that needs to be addressed as an emergency. The problem is the hearing loss symptom feels the same. For this reason, all sudden hearing loss should be treated with urgency.
If a sudden sensorineural hearing loss is diagnosed and treated within 24-48 hours of onset, the odds of all or some of the hearing returning are best. Even in the best case scenarios, recovery is only experienced 50% of the time. Not great odds, but by day 14 the recovery rate is close to 0%. According to the American Hearing Research Foundation, sudden (sensorineural) hearing loss is hearing loss over 30 dB over at least three frequencies occurring over a period of 72 hours or less. Some people report that they woke up with the hearing loss. Usually only one ear is affected. Tinnitus (ringing or buzzing) in the affected ear often occurs. Vertigo(dizziness) also is sometimes experienced. Patients, and also sometimes physicians, think that the hearing difficulty is due to a cold, middle ear fluid or sinus difficulty. Treatment for these will not help a sensorineural hearing loss.
If you or a loved one experiences sudden hearing loss, call an ear, nose and throat (ENT) physician or an audiologist as soon as possible. Make sure you tell them that the hearing loss is sudden, they will know that this is an emergency and will get you in within a day or two. If they don’t, call someone else. Since the ENT will want results from an audiologist, you will save time by going to an audiologist first. The audiologist will then refer you to an ENT. The audiologist will look in your ear and evaluate hearing with earphones or insert phone and a bone conductor. This will let her know whether the hearing loss is sensorineural (inner ear) or conductive (middle ear). Either way the results should be shared with an ENT.
The audiological information is crucial in treating patients with sudden hearing loss. 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 ototoxic medications. Most of the time, the cause of sudden hearing loss is unknown. Diagnosis involves case history, physical examination and audiological evaluation. Other tests such as blood tests and/or MRI testing may be ordered.
The most common medical treatment for sudden hearing loss is corticosteroids(pills). Again treatment needs to take place within 10 days of onset to have the best chance of hearing recovery. Sometime recovery is partial. If clarity of hearing is preserved, then a hearing aid may be recommended once hearing is sable.