If you’ve ever seemingly out of the blue experienced hearing loss in one ear, it can be alarming. This condition is called sudden sensorineural hearing loss, or SSNHL, and is an unexplained or rapid loss of hearing — one that is not caused by a “noise trauma,” such as an exploding firecracker right next to the ear.

Image result for sudden hearing lossMarked by inflammation of the inner ear, SSNHL usually affects only one ear. For some people, SSNHL may be accompanied by tinnitus (ringing of the ears) and vertigo.  SSNHL strikes about 66,000 people in the United States every year, according to an American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) clinical practice guidelines. Although it can develop at any age, SSNHL is most often seen in adults in their late 40s or early 50s.

“It can be very scary for patients — it’s not only disorienting to not be able to hear, but with these symptoms, people worry they’re experiencing a life-threatening emergency such as a stroke,” explains Seth Schwartz, an otolaryngologist at the Virginia Mason Medical Center in Seattle and a co-author of the guideline.

Here’s what you need to know — and do — if you experience sudden hearing loss.

Important to get a prompt diagnosis

If you’re suddenly having trouble hearing out of one ear, it may be tempting to chalk it up to clogged ears from a respiratory infection or allergies and assume it will get better on its own. And about half of people with SSNHL regain at least some of the hearing in the affected ear spontaneously, according to the AAO-HNS. This usually occurs within one to two weeks.

But prompt diagnosis and treatment can improve those odds, Schwartz says: “You always want to see your primary care physician within 24 to 48 hours.”.

Your doctor will start by checking to make sure there’s no physical reason for your sudden hearing loss, such as earwax blocking your ear canal, fluid in your ear or a punctured eardrum. The physician will also consider possible causes such as head trauma, exposure to certain chemotherapy drugs or neurological diseases like multiple sclerosis. For about 90 percent of people, however, doctors are not able to pinpoint the trigger.

Some research suggests a link with metabolic syndrome — a cluster of conditions that include elevated blood pressure, blood sugar and cholesterol, as well as a larger than normal waist circumference.

See an audiologist

If a physical exam reveals no obvious reason for your sudden hearing loss, your next step should be to see an audiologist, ideally within a few days.

Image result for one sided hearing lossThe audiologist will perform a pure-tone test, where you listen for beeps while wearing earphones and raise your hand whenever you hear one. If it determines that you’ve lost at least 30 decibels of hearing in one ear in three consecutive frequencies, you’ll be diagnosed with SSNHL.

“This drop would make it hard for you to hear conversational speech,” says Deborah Berndtson, associate director of audiology practices at the American Speech-Language-Hearing Association.

And if you’re also experiencing symptoms like dizziness, your audiologist can perform tests such as electronystagmography, in which small electrodes are placed on the skin around your eyes to measure your eye movements. This helps determine how well your vestibular system — which is connected to your inner ear and helps with balance — is working.

See an ENT specialist

Image result for ent specialistOnce you’ve been told you have SSNHL, see an ear-nose-throat specialist as soon as possible. He or she may have you undergo imaging tests such as MRI to look further for a physical cause. (In rare instances, vestibular schwannomas, benign growths on the nerve that connects the ear to the brain, may be the cause of SSNHL.)

Some doctors may also order lab tests to look for markers of autoimmune disorders or viruses.

Effective remedies, measures

Although sudden hearing issues may resolve on their own in about half of those who experience one, experts can’t predict who will be among them, according to the AAO-HNS. People with SSNHL who also have vertigo may have a poorer prognosis, however. So talk to your doctor about the benefits, potential risks and possible effectiveness of treatment.

The gold standard for sudden hearing loss has been corticosteroids, says Erika Woodson, an otolaryngologist at the Cleveland Clinic. These medications work by reducing the inflammation and swelling thought to cause hearing loss and dizziness.

For SSNHL, steroids may be given in pill form or as an injection into the eardrum. Both ways are equally effective, according to a 2011 randomized trial published in the Journal of the American Medical Association. There’s also some research to suggest combining both forms may be slightly more effective than one alone.

But when it comes to steroids overall for SSNHL, the guideline published in August 2019 “points out that they may not be that helpful,” Schwartz says. And like all medications, they have their side effects, including weight gain, mood changes, trouble sleeping and high blood pressure and blood sugar.

If you and your doctor determine that steroids are a good option for you, you’ll need to begin treatment fairly quickly.

You may also want to ask your ENT about hyperbaric oxygen therapy (HBOT). This involves breathing pure oxygen in a special chamber as a way to boost oxygen to your ear and brain.

Studies on HBOT have been mixed, but some research suggests that doing it within two weeks of the onset of symptoms in combination with steroids or within four weeks in people who don’t respond to steroids may help.

Some doctors also prescribe antiviral medications, but the AAO-HNS doesn’t recommend routine use of these drugs because there’s no evidence of their benefit.

Cochlear implants, other aids

Image result for one sided hearing lossIf your hearing doesn’t improve within three months, your ENT can refer you back to an audiologist to get fitted for a hearing aid, or if your hearing loss is very severe, discuss the possibility of a cochlear implant.  A cochlear implant is a small electronic device that is surgically implanted. It bypasses the damaged portions of your ear and stimulates your auditory nerve directly.

For a hearing problem or tinnitus that lingers, your doctor may also recommend audiological rehabilitation, which may include behavioral strategies (such as meditation for relaxation), assistive listening devices and training to help you maintain focus in noisy situations, according to the Hearing Loss Association of America.

If you or someone you know has experienced sudden one-sided hearing loss, contact us today and our team of highly trained audiologists and ENT specialists can work together to accurately diagnosis and come up with the most effective treatment plan.

Image result for one sided hearing loss


Source: Washington Post