THE DANGER OF SUDDEN HEARING LOSS
Typically people who suffer from hearing loss are either born with the condition or develop it over time, but there is another kind of hearing loss that is destructive and abrupt. Sudden sensorieneural hearing loss (SSHL) is an unexpected loss of most or all hearing in one or both ears occurring within 3 days or less. Sudden hearing loss is considered an emergency, but those experiencing it often don’t understand they need to immediately seek medical help. The tendency with sudden hearing loss is to wait and see if it clears up. That’s because loss of hearing usually is associated with clogged feeling in the affected ear and no pain. So it is mistakenly believed to be temporary, resulting from a cold or allergy attack. But waiting to treat the sudden inner ear problem often results in permanent hearing loss.
SSHL is due to sudden swelling of the inner ear nerve endings that are inside the skull. This part of the ear is not visible using the regular otoscope light in the outer ear canal.
There are very few ways for a person to know if they are suffering from this sudden, possibly permanent, hearing loss instead or the more common reasons such as wax plugging the outer ear or build up of fluid behind the ear drum like in a head cold or from recent plane travel. Because this sudden hearing loss doesn’t always have a direct link to other ear problems such as dizziness, and if it occurs without pain, it can seem even less like an emergency.
Many people afflicted with sudden hearing loss never realize there is a limited amount of time to seek help. It’s best for a person to seek help within 24-48 hours to regain full hearing. However, there are examples of patients treated a few weeks after the incident regaining partial to full hearing, so even if you have passed that golden hour, get to a doctor.
Unfortunately a family doctor, minor illness clinic or even a hospital ER often has limited experience with sudden hearing loss. Overall it is a rare condition and may not be even considered as a possibility. I have been a Board Certified ENT specialist for 34 years, and examining an ear with precision is frequently difficult. Many health care providers, when faced with a person with hearing loss incorrectly see fluid behind the eardrum and treat that condition with antibiotics, antihistamines or nasal sprays like Flonase. Unfortunately, those treatments do not work, but the person affected will try them for 2-3 weeks before going back.
There is one fairly simple and totally free way for a person to determine the cause of sudden loss of hearing in one ear — humming. When you hum the sound goes directly through the bone of your skull into your inner ear. If the inner ear is damaged the humming is not heard on that side. But if the ear is plugged with wax or fluid behind the drum, the humming will be LOUDER in that ear. (You can prove this yourself by humming then plugging one ear with your finger. The sound of the hum should be louder on that side). So if you hum and it sounds louder in your “bad” ear, it is usually not an emergency.
As I said, if a person has sudden onset inner ear hearing loss, the chance of recovery is best if treatment is started as soon as possible. The recognized best therapy is either high dose steroids by mouth, or after totally numbing the ear, injecting steroids through the eardrum. Recent studies have shown a combination of the two is actually best.
My office staff includes an experienced Audiologist who can make the diagnosis with 10 minutes of testing. While this problem of SSHL is considered to be rare, I probably see 5-10 people a month with it, and I have been fortunate enough to get most of them better.