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When Your Hearing Disappears Suddenly

Collet-Fenson, Duncan

doi: 10.1097/01.HJ.0000616132.55619.ef
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Mr. Collet-Fenson is the head audiologist and managing director of Aston Hearing. He was awarded the U.K. and European Audiologist of the Year in 2016, and serves as the treasurer of the Association of Independent Hearing Healthcare Practitioners.

Each year, between five and 30 per 100,000 individuals unexpectedly lose their hearing in the space of a minute or over a few hours because of sudden sensorineural hearing loss (SSNHL). Sadly, immediate medical help is often not sought because the symptoms of SSNHL and other types of hearing loss are very similar and can be mistakenly put down to a temporary blockage caused by wax or fluid. However, SSNHL is a medical emergency, and all types of sudden hearing loss must be checked quickly to rule out anything serious.

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WHAT IS SSNHL?

Also known as sudden deafness, SSNHL is defined as a drop of at least 30 dB in more than three frequencies over a short period of time. It most commonly affects just one ear, although it can affect both ears. It seems to be most common between the ages of 30 and 60, and around 50 percent of people recover within two weeks without any specific treatment. To improve the chances of recovery, early treatment with steroids and antiviral medication may be advised where appropriate, taking into account the possible side effects of such treatments. This medication should be offered provided your individual health needs are assessed and there are no other health contraindications for treatment.

If SSNHL occurs, you might notice a pop in the affected ear, after which either the hearing may immediately disappear, or it could slowly decline over a few hours. It may only be apparent when you try to use the phone on the affected ear and/or may be accompanied by vertigo (dizziness), tinnitus (ringing in the ear), or a feeling of fullness in the ear.

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WHAT SHALL I DO IF I LOSE MY HEARING SUDDENLY?

SSNHL is a medical emergency, can result in permanent hearing loss, and requires swift attention. If you have sudden loss of hearing, seek immediate medical advice from an audiologist or go straight to an emergency department or an ear, nose, and throat (ENT) specialist. Prompt action and treatment with steroids may improve the chance of reversing the hearing loss. Patients should request an emergency audiogram because it often provides evidence of SSNHL and can rule out ear wax or other possible causes of hearing loss.

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HOW IS SSNHL TREATED?

High-dose oral steroids are the most common treatment, although occasionally the patient may need steroid injections directly into the ear. Patients have the best possible outcome if treated within two to three days after the sudden hearing loss occurs. Waiting even just two weeks for medical attention may miss the opportunity for steroids to potentially improve your chance of recovery. You may need follow-up tests and repeated hearing assessments to monitor your progress or recovery.

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WHY DOES SSNHL HAPPEN?

SSNHL is thought to have various possible causes, including viral infections, blood circulation problems, head trauma, benign tumors on the hearing and balance nerves, or autoimmune diseases. In most cases, the exact cause is never found. SSNHL can happen unexpectedly at any age regardless of any previous hearing issues, and only 10 percent of those diagnosed have an identifiable cause.

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CAN YOU PROTECT AGAINST SSNHL?

Prevention is difficult as there are no clear-cut ways to deter the onset of SSNHL, but monitoring your general health and protecting your ears where possible are advisable.

  • Protect your hearing at work where necessary and when in loud environments.
  • Wear a helmet when playing contact sports or riding a bike.
  • Monitor your blood pressure because high blood pressure can cause a vascular episode in the cochlea.
  • Be aware of tinnitus (ringing in the ear)—sudden onset or a change in tone.
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WHO IS MOST LIKELY TO EXPERIENCE SSNHL?

If you have recently experienced a trauma to the head, ear infection, blood circulation issues, Ménière's disease, or neurological disorders such as multiple sclerosis, you may be at increased risk of SSNHL. However, SSNHL can occur without any warning, so it's important that you take any sudden hearing loss seriously.

Acknowledgment: Thank you to Ian Bottrill, an ENT lead consultant surgeon for Buckinghamshire Hospitals NHS Trust, for his contribution to this article.

Download a printable SSNHL Checklist here: bit.ly/SSNHLChecklist

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