Sudden hearing loss, known as Sudden Sensorineural Hearing Loss (SSHL) in the medical world, is a perplexing and distressing phenomenon that requires immediate medical attention. As an audiologist, one very important role of mine is to help the general public recognize and understand the symptoms of SSHL so that timely and appropriate care can be provided.

Symptoms of Sudden Sensorineural Hearing Loss (SSHL)

1. Sudden Hearing Loss: Patients often report waking up or going about their daily routine when they suddenly notice a significant reduction in their ability to hear sounds. They may feel as though their ear is “blocked” or “stuffed up,” but unlike a typical ear blockage, no amount of self-clearing or ear drops seems to restore their hearing.
2. Unilateral or Bilateral Loss: SSHL can affect one or both ears, but it often occurs unilaterally, meaning it affects only one ear.
3. High-Pitched Tinnitus: Many patients experiencing SSHL also report the presence of tinnitus, a sound only the patient can hear that manifests as ringing, buzzing, hissing, or whistling in the affected ear. It is often described as high-pitched and persistent, further adding to the distress of the patient.
4. Fullness Sensation: Some individuals may describe a feeling of fullness or pressure in the affected ear. This sensation can be similar to what one might experience during a change in altitude or when dealing with congestion.
5. Difficulty Understanding Speech: Patients may notice that understanding speech becomes more challenging, especially in noisy environments or during conversations with multiple people. 
6. Vertigo/Imbalance: In some cases, patients with SSHL may experience episodes of vertigo or imbalance.

Diagnosis

Timely medical intervention for sudden hearing loss is crucial, as the chances of recovery are highest within the first two weeks of onset. Typically, your physician will require confirmation from an audiologist that the loss is indeed sensorineural and not due to wax in the ear canal or fluid in the middle ear before providing medical treatment.

Therefore, patients experiencing symptoms of a sudden hearing loss are urged to visit an audiologist for testing ASAP. Patients do not need a referral from their doctor to have their hearing tested. When contacting an audiology clinic, patients must indicate they are experiencing symptoms of a sudden hearing loss to ensure they are seen the same day.

Following a comprehensive hearing evaluation from the audiologist, your physician may order diagnostic imaging tests such as an  MRI or CT scan to rule out structural abnormalities that may be affecting auditory function.

Treatment and Prognosis 

While some patients spontaneously recover without intervention, others may require treatment. Common treatment approaches include: 

Corticosteroids: Oral or intratympanic corticosteroids are often prescribed to reduce inflammation and swelling in the inner ear, potentially improving hearing recovery. 

Hearing Aids: In cases of incomplete recovery or permanent hearing loss, hearing aids can offer significant benefits and improve the patient’s quality of life. 

Aural Rehabilitation: Audiologists play a pivotal role in providing aural rehabilitation, helping patients adapt to their changed hearing abilities and facilitating communication strategies. 

Causes and Risk Factors 

Despite extensive research, the precise cause of SSHL remains unknown in most cases. Some theorized causes  include: 

1. Viral Infections: Certain viruses, such as the herpes simplex virus, varicella-zoster virus (chickenpox and shingles), and cytomegalovirus (CMV), can directly or indirectly attack the inner ear structures, including the cochlea and auditory nerve, leading to sudden hearing loss.
2. Vascular Issues: Disorders affecting the blood supply to the inner ear can result in SSHL. Reduced blood flow to the cochlea can lead to oxygen and nutrient deprivation, causing damage to the delicate hair cells or the auditory nerve.
3. Autoimmune Diseases: Some autoimmune conditions cause the body’s immune system to mistakenly attack the inner ear tissues, leading to inflammation and hearing loss.
4. Ototoxic Medications: Certain medications that are toxic to the inner ear (ototoxic drugs) can cause sudden hearing loss as a side effect. 
5. Trauma or Head Injury: In some cases, head trauma or physical injury can damage the cochlea or auditory nerve resulting in a SSHL. 
6. Tumors or Growths: Although relatively rare, non-cancerous tumors, such as acoustic neuromas, can develop on the auditory nerve or other structures in the ear. These growths can put pressure on the nerve, leading to sudden hearing loss.
7. Neurological Conditions: Certain neurological conditions, such as multiple sclerosis (MS), have been linked to SSHL. 
8. Genetic Predisposition: In some cases, there may be a genetic predisposition to sudden sensorineural hearing loss. Specific genetic factors may make certain individuals more susceptible to experiencing SSHL.

Conclusion

Any sudden changes in hearing deserves immediate attention from an audiologist. If you or a loved one are experiencing symptoms of a sudden hearing loss contact our clinic as soon as possible to schedule a comprehensive hearing evaluation. If you are experiencing symptoms outside of regular business hours, visit your nearest emergency department.