Communication Matters

Sudden Hearing Loss - A Medical Emergency

Laura L. Brady, AuD, CCC-A | Posted on March 23, 2020

Ruth2Sudden Sensorineural Hearing Loss (SSHL) is a sudden, unexplained, change in hearing that happens all at once or over a period of a few days and often affects only one ear.    

It is often reported as being noticed upon waking in the morning or when a person tries to use the phone to that ear. Others symptoms can include a feeling of fullness in the ear, ringing in the ear (tinnitus) or dizziness/vertigo. Some people have reported hearing a surprising loud “pop” sound just before the dramatic hearing change.  

Sudden hearing loss should be considered a medical emergency. If suspected, you should visit a doctor immediately.

Sadly, sometimes people with SSHL put off seeing a doctor because they believe the change in hearing is due to allergies, a sinus infection, a cold, or just a build up of ear wax plugging the ear canal.

Most often affecting adults in their late forties and early fifties, experts estimate that SSHL impacts between one and six people per 5,000 every year. But, this number may actually be much higher as SSHL cases often go unreported/undiagnosed.    

A variety of disorders affecting the ear can cause SSHL, but in only about 10 percent of the cases can a cause be identified. Some of the conditions are infections, head trauma, autoimmune diseases, drugs that treat cancer/severe infection/blood circulation problems, multiple sclerosis, and Meniere’s Disease.

Although rare, sudden hearing loss in men taking prescription medication for erectile dysfunction (Cialis, Levitra, and Viagra) has been reported. Over 2 million prescriptions were written for Viagra alone in 2016. It isn't clear though, if the sudden change in hearing was directly caused by the medication or by another preexisting heath condition.

For sudden deafness without an obvious, identifiable cause, the doctor should request a full hearing evaluation performed by an audiologist within a few days of the onset of symptoms. Your doctor may also order additional tests to try to determine an underlying cause such as blood tests, imaging studies like an MRI, or balance tests.

The most common treatment for SSHL is corticosteroids. Steroids should be used as soon as possible to be the most effective and may even be prescribed before all test results come back. Treatment that is delayed for more than two to four weeks is less likely to reverse or reduce permanent hearing loss.

Steroids work by decreasing swelling, and by helping the body fight infection.  Prior to 2011, steroids were most often prescribed in oral pill form. Later research showed that injections of steroids directly through the eardrum was as effective as oral medication. Doctors started prescribing injections of steroids into the middle ear allow the medication to be applied more directly to the ear and can be a good option for people who should not take oral steroids (or who want to avoid the side effects). The injections can be performed in the offices of many ENT physicians (otolaryngologists).

Other treatment may be needed if your doctor discovers an underlying cause of the SSHL. For example, if SSHL is caused by an infection, the doctor may prescribe antibiotics or antiviral medications. If you took a drug that was toxic to the ear, you may be advised to switch to another drug. If an autoimmune disorder is suspected as a cause, the doctor may prescribe medication to suppress the immune system. 

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