Sudden Hearing Loss

Sudden hearing loss is alarming as it often occurs for no obvious reason. Although the condition is usually treatable with medication or minor procedures, it should be considered an emergency. There are a few, fortunately less common, causes of sudden hearing loss that must be treated right away to avoid further damage.

• Defined as the inability to hear out of one or both ears that occurs over less than 72 hours
• Can be a total or partial loss

In many cases, sufferers wake up with hearing loss when they had no symptoms upon going to bed. It can also occur during waking hours when someone experiences an instant hearing loss with no apparent cause. Sometimes the loss is first noticed when someone holds the phone to the affected ear and realizes the sound is muffled.

Besides being unable to hear, patients also usually experience sensations of fullness in the affected ear canal. They report that their ears feel stopped up. This sensation mimics what many people experience when they are suffering from a cold. Unfortunately, this may cause them to delay seeking treatment as they wait for the condition to resolve itself.

There is a quick self-diagnostic that people can perform to reassure themselves if they experience sudden hearing loss. If they can hear themselves hum in the ear with the loss, the loss is most likely the result of a fluid or wax blockage that can be successfully treated.

Early symptoms may be subtle and are sometimes assumed to be age-related hearing loss, since this is the most common symptom associated with the condition. If nerves are not being compressed, there may be no symptoms experienced. When hearing loss is experienced because of an acoustic neuroma, it’s usually gradual and asymmetric (present in one ear only). Hearing loss may be accompanied by tinnitus (persistent sound/ringing in the ear). In some people, symptoms will progress rapidly, although gradual progression is more common. Additional symptoms associated with acoustic neuromas may include:

• Feeling of “fullness” in the affected ear
• Dizziness or vertigo
• Difficulty with balance
• Facial weakness or numbness
• Hoarseness and difficulty swallowing
• Unsteadiness
• Taste changes

Severe symptoms that include mental confusion should be treated right away. This is usually a sign that nerve compression is affecting certain parts of the brain.

The simplest causes of sudden hearing loss are those that result from a buildup of fluid or wax. Fluid buildup is often the result of an allergy, and it can create an environment that allows for the growth of bacteria. The accumulation of fluid or wax is not life-threatening, but these conditions are uncomfortable and disconcerting and may influence the patient’s equilibrium. If fluid buildup behind the eardrum is not treated in a timely manner, it can eventually cause enough pressure to rupture the membrane.

Sudden hearing loss is less often caused by more serious conditions. These can include viruses, tumors and strokes in the inner ear.

Only about 3 percent of patients with sudden hearing loss will be found to have a tumor. These tumors are called acoustic neuromas and affect the auditory nerve. The auditory nerve carries signals from the inner ear to the brain. Tumors almost always affect hearing in only one ear. If left untreated, these tumors will cause a progressive, permanent loss of hearing over time. Acoustic neuromas grow slowly and do not metastasize into other tissues.

A common virus that can produce hearing loss is the virus that causes Lyme disease. Other viral and bacterial infections, as well as some autoimmune disorders, may also be implicated.

Before treatment can begin, the doctor must first diagnose the cause of the hearing loss. The first check will be to look for physical obstructions. This requires an examination of the entire acoustic structure from the outer ear through the middle ear and into the inner ear. The doctor will be looking for abnormalities, blockages and inflammation.

If a tumor is suspected, an MRI may be performed. This will detect acoustic neuromas or any other tumors that are impinging on the acoustic nerve.

Occasionally, blood work will be done to look for infectious agents. Lyme disease or other infections can be detected through the appropriate blood tests. They may also uncover previously undiagnosed autoimmune disorders that could be producing hearing loss.

The most common treatment for sudden hearing loss is the oral steroid called prednisone. This drug reduces inflammation and suppresses immune response. In some cases, an injection of steroids directly into the ear is called for. These injections are called intratympanic injections.

If the cause of the hearing loss is a simple buildup of wax, called a cerumen impaction, this blockage can be loosened with oil and then flushed or suctioned out by the doctor. If an allergy is causing a fluid buildup, treating the allergy will also treat the hearing loss. This is done with decongestants and antihistamines.

When hearing loss is the result of a viral or bacterial infection, those infections must be cleared. They can be treated with the appropriate antiviral or antibacterial medications.

When a tumor is found to be the cause of sudden hearing loss, it can be treated with radiation, or surgery to remove the tumor may be recommended.