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Fact Checked

Sudden Sensorineural Hearing Loss: A Medical Emergency

When you think of a medical emergency, you probably think of a heart attack or stroke. But did you know that a sudden hearing loss is also a medical emergency?

As someone with frequent ear infections, I’m not usually too alarmed if I have discomfort or a clogged feeling in my ears. But recently, I had a frightening experience that I feel is essential to share. 

I woke up one day, feeling very clogged in my left ear. I felt like I was in a tunnel! 

I thought it must be a buildup of wax, nothing unusual for me, so I was not alarmed at this point. I called my Ear, Nose, and Throat (ENT) doctor, and I was told to come right in. 

I was shocked when the ENT told me that there was no wax. I had entirely lost hearing in my left ear. My diagnosis was sudden sensorineural hearing loss (SSHL). It was a terrifying experience. 

My ENT explained that I may or may not recover my hearing with a high dose of steroids and antivirals. In the next few days, I took my medications and thanked my lucky stars when my hearing mostly returned. 

Through this experience, I learned that SSHL is a medical emergency. I feel a responsibility to tell others about this experience. If I can save even one person’s hearing, it will be worth it. 

What are the Different Types of Hearing Loss?

Hearing loss can affect people of any age and can have various causes. The different types of hearing loss include:

  • Sensorineural hearing loss: due to damage to the inner ear or hearing nerve.
  • Conductive hearing loss: Earwax, a foreign object, or an infection blocks sound in the middle or outer ear.
  • Mixed hearing loss: a combination of both types of hearing loss. 

What is SSHL?

Sensorineural hearing loss is the most common of the three types of hearing loss. The cause of a patient’s sensorineural hearing loss is often unknown but may include aging, noise exposure, injury, infection, autoimmune disease, or certain medications. 

Sudden sensorineural hearing loss, or SSHL, can occur suddenly or over several days. SSHL is also called sudden deafness.

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How Common is SSHL?

What are the Symptoms of SSHL?

SSHL often affects only one ear. Like me, many patients with SSHL often notice hearing loss when waking up. Others notice that they can’t hear when using the phone. Some feel a loud pop, and then their hearing disappears. 

Besides hearing loss, other symptoms of SSHL include:

  • Full feeling in the ear
  • Dizziness 
  • Tinnitus (ringing in the ear)

If you experience any of these symptoms, even if you think, “it’s just wax,” it’s better to be safe than sorry. SSHL is a medical emergency. Contact your doctor immediately. A quick diagnosis increases the chances of regaining your hearing. It’s best if you can see an ENT specialist.

How is SSHL Diagnosed?

Your ENT will look for the cause of your hearing loss. He or she will check for wax or fluid in the ear. Your ENT will most likely perform a hearing test to get a full picture of the hearing loss. Other tests may be necessary, such as lab tests or an MRI, to look for a cause. 

What is the Treatment for SSHL?

Corticosteroids (steroids) are the most common treatment for SSHL. Often, there is no known cause of SSHL, and steroids can decrease inflammation and swelling. 

Your ENT may prescribe oral steroids, such as prednisone. Or, he or she may inject steroids into the middle ear. This procedure is called an intratympanic injection.

For the best outcome, your ENT will have you start treatment immediately. Even if you are waiting for test results, you can begin treatment. 

Your doctor may prescribe additional medications. For example, if he or she thinks a viral infection could be causing your SSHL, your doctor may also prescribe an antiviral drug. A bacterial infection requires antibiotics. 

You may require hearing aids or cochlear implants if your hearing loss does not improve. 

If I have SSHL, will my Hearing Return?

In the best-case scenario, your hearing will return to normal. Seeing your doctor promptly will increase your chance of recovery. Waiting two or more weeks from when symptoms begin can decrease your chance of regaining hearing. 

Left untreated, 25-30% of patients with SSHL will spontaneously improve, but not necessarily to normal. Prompt treatment increases your chance of improvement to 50% or more. 

When Should I See My Doctor?

If you have any hearing loss symptoms, fullness, a clogged feeling, or something just doesn’t feel right, call your ENT immediately. If you don’t have an ENT, contact your primary care provider. He or she can examine and treat you, or refer you to an ENT, if necessary. 

Although it may not feel like an urgent matter, SSHL is a medical emergency. Prompt treatment will allow you the best chance for recovery. 

References

  1. Types of Hearing Loss. Johns Hopkins Medicine website. Available at https://www.hopkinsmedicine.org/health/conditions-and-diseases/hearing-loss/types-of-hearing-loss Accessed August 27, 2020.
  2. Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013;34(9):1586-1589. DOI:10.1097/MAO.0000000000000222
  3. Sudden Deafness. National Institute of Health: National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at https://www.nidcd.nih.gov/health/sudden-deafness Accessed August 27, 2020.
  4. Reversing Sudden Deafness. The DANA Foundation Website. Available at https://www.dana.org/article/reversing-sudden-deafness/ Accessed August 27, 2020
Published September 24th, 2020 by Dr. Karen Berger, PharmD
Fact Checked by Chris Riley

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