Imagine the shock of waking up in the morning to find your hearing is gone. The scenario described is not a nightmare but a relatively common condition known as a sudden hearing loss (SHL). This medical emergency requires immediate attention, affects all age groups, and is most common with those in their fifties and beyond.
How Does It Happen
There are numerous causes of SHL and rarely is the underlying cause diagnosed. The majority of patients with SHL can’t determine what caused their hearing loss. A study of the medical history is often used to make the determination. Although the pathology is difficult to identify, a few of the most common causes are listed below:
- Prolonged exposure to a loud noise
- A head injury
- A malformed inner ear
- Neurologic conditions
- Immune system diseases
- Aging
- Meniere’s disease (an inner ear disorder)
- Blood circulation problems
Symptoms
SHL is a hearing reduction that is greater than 30 dB over at least three adjacent frequencies, for 72 hours or less. Estimates say about one-third of people who discover SHL do so upon waking in the morning. Fortunately, both ears are involved only a small percentage of the time. It may be sudden, such as when you can’t hear a telephone, or it may be a gradual loss that includes the following symptoms:
- An occurrence of a hearing loss without a recognizable cause
- No earache present
- Hearing loss concentrated in one ear only
- Dizziness
- A loss of sensation in the outer ear
- Pressure in the ear
- Tinnitus (ringing in the ear)
Diagnosing the Problem
An ENT specialist can diagnose SHL using ear microscopy and a hearing test. A process of elimination that includes blood tests and a measurement of blood pressure makes the determination. The ear doctor can use an otoscope to determine if obstructions or injury to the outer ear is the cause. The hearing evaluation which may include a tuning fork test and pure-tone audiometry can determine if the problem is in the inner or middle ear. The doctor can then determine if the loss is high, mid, or low-frequency.
Treatment
SHL treatment involves a review of your medical history, a physical examination, and laboratory results. If a definitive cause is not determined, then the treatment will be based upon the most likely cause. There is no preferred method of treating SHL. Some of the most common methods of treatment include:
- Vasodilators
- Rheologic agents
- Anti-inflammatory agents
- Anti-viral agents
- Diuretics
- Hyperbaric oxygen therapy
The annual incidence of SHL is estimated to be between 5-20 cases per 100,000 people. As many cases go unreported, this number could easily be higher. The female to male distribution seems to be equal. All age groups are affected, primarily ages 40-54. If you suddenly experience a hearing loss, or gradually experience a loss that includes the symptoms listed above, seek medical attention. An ear exam along with a review of your medical history will assist medical professionals in finding the best treatment for you.
