Sudden change in hearing for anyone is a troubling experience. The degree to which hearing changes and the accompanying symptoms will bring patients in to see the doctor the same day or as soon as they can find the time. For patients with a sudden change in hearing, time can be of the essence and they should be seen as soon as possible. The notion of waiting to see if the loss will go away on its own can leave the patient with a permanent hearing loss. Research has shown that the patient who is seen within the first 24 to 48 hours of hearing loss has greater success in the recovery of hearing.
A sudden sensorineural hearing loss (SSHL) is a change in hearing of 30dB over 3 contiguous frequencies. It usually occurs over several hours and may vary in severity from mild to profound and frequencies affected. A patient may have associated dizziness, ear fullness and/or ringing in the ear prior to the loss. These symptoms may continue or gradually subside. SSHL most often is unilateral but can be bilateral and affects both men and women equally.
Generally, it has been found that over 60% of cases are viral in nature. However, a sudden hearing loss can have many etiologies, ranging from simple cerumen impaction, to an acoustic neuroma.
Ototoxic drugs, strenuous exercise, barotrauma, and reduction in blood supply are a few of the possible causes of hearing loss. Often, the cause remains idiopathic. A thorough medical exam should be completed to rule out those hearing losses that can be easily treated. The primary care physician will be the patient’s first source for help. If there are no obvious signs of cerumen impaction or middle ear infection, referral to an Otolaryngologist (ENT) is crucial.
The ENT will first order a full hearing evaluation. The severity and configuration of the loss will be determined. Blood tests, MRIs and other special testing may also be done. Spontaneous recovery of the hearing loss occurs in over half of the cases usually within a few weeks. Nearly a third of all losses are permanent. The prospect of having a permanent hearing loss can be daunting. A regimen of steroids may be initiated with possible use of an anti-viral medication as well. The effectiveness of treatment can vary and those patients who have milder hearing losses may experience better recovery than those with profound losses. Other drug therapies may include those to reduce inner ear fluid or increase inner ear blood supply. The earlier the treatment is initiated, the greater chance for a successful outcome.