Sudden Sensorineural Hearing Loss
Sudden hearing loss syndrome is defined as a sudden decrease or loss of hearing in one or both ears. This may be preceded or accompanied by a static sound or ringing in the ears and/or dizziness up to 12 hours before or at the time the hearing loss occurs. Since a sudden hearing loss can be caused by a viral infection of the inner ear and hearing nerve, tumour of the hearing nerve, blockage of the blood supply to the inner ear, or noise. It must be stressed that if any sudden change in hearing is noted, it is imperative to be seen within 24-48 hours by an ear, nose and throat doctor (Otolaryngologist).
As there is often no clear cut reason, the following are possible contributory causes: sudden pressure changes in the ear during airplane travel and scuba diving, unusual physical exertion or strain, previous ear surgery, recent upper respiratory infection, antibiotics that are toxic to the ears, and acoustic trauma (sudden or prolonged loud noise exposure). In a majority of cases, the exact etiology is unknown and the underlying pathology is suspected to be due to problems with inner ear circulation or a viral infection. It is well known that patients have a better chance of recovery of the recent loss of hearing when seen early in the course of their ailment.
An initial assessment of the patient who reports sudden hearing loss will include the following: History and ear, nose and throat examination, blood tests and hearing tests. Depending on the outcome of those tests, further tests may be recommended such as a MRI scan of the inner ear.
The history may alert the ENT doctor to situations which may have caused the loss, such as upper respiratory infection, air travel, scuba diving, history of smoking, the taking of birth control pills or other ototoxic medications and existing medical disorders.
The ear, nose and throat examination will show any abnormalities such as excessive wax in the outer ear canal, infection or fluid in the middle ear, or perforation of the eardrum.
Blood tests check for elevated levels of triglycerides and/or cholesterol, syphilis, infection, diabetes, thyroid and kidney disorders, inner ear infections and auto immune disease.
Treatment of sudden hearing loss varies, depending on the suspected cause. The patient may be given medicine to increase circulation of the inner ear, steroids and anti-viral medications. Sometimes, injections of steroids into the ear can help patients who have not responded to oral medications. The patient may be advised to stop the use of birth control pills, smoking, drugs, alcohol, caffeine, or to restrict the amount of strenuous activity, as well as to watch his intake of fats and cholesterol.
In summary, anyone who notices any sudden loss in hearing, regardless if there are any accompanying symptoms (fullness in the ears, ringing or dizziness), should be seen by their ENT doctor within 24-48 hours. Recovery of the hearing loss depends not only upon the early diagnosis of the cause of the hearing loss, but also on the early initiation of appropriate treatment