Have you ever woken up one morning and felt like something was off with your hearing? Or maybe you were on a phone call and realized one ear just wasn't picking up sound as it should? You might have encountered sudden deafness, a condition that can be quite alarming.
What Exactly is Sudden Deafness?
Sudden sensorineural (“inner ear”) hearing loss (SSHL), which we commonly refer to as sudden deafness, is a baffling situation where your hearing vanishes rapidly, either all at once or over a few short days. This occurs because something goes wrong within the delicate sensory organs of the inner ear. More often than not, it's just one ear that's affected.
Many people first notice SSHL when they wake up. Imagine starting your day, only to find that the world seems strangely quiet on one side. Others realize something's amiss when they try to use that particular ear, like when they hold a phone to it. Some even hear a loud “pop” right before their hearing starts to fade. Alongside the hearing loss, you might experience other symptoms too. There could be a feeling of fullness in your ear, as if it's stuffed, or you might feel dizzy. Ringing in the ears, known medically as tinnitus (https://www.nearity.co/blog/tips-for-getting-rid-of-the-annoyance-of-tinnitus), is also a common sign.
It's crucial to understand that sudden deafness is a medical emergency. Sometimes, patients delay seeing a doctor because they assume it's just allergies, a sinus infection clogging things up, or earwax blocking the ear canal. But don't make that mistake. Even though about half of those with SSHL will recover some or all of their hearing spontaneously, usually within one to two weeks of the onset, delaying diagnosis and treatment can seriously reduce the effectiveness of any potential treatment. The sooner you get help, the better your chances of regaining at least some of your hearing. Statistically, experts estimate that between one and six people out of every 5,000 experience SSHL each year. However, the actual number could be much higher since it often goes undiagnosed. This condition doesn't discriminate by age, but it tends to strike adults in their late 40s and early 50s more frequently.
What Causes Sudden Deafness?
The causes of SSHL are a bit of a mystery. Only around 10 percent of diagnosed cases have a clearly identifiable cause. There are several factors that could be at play:
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Infections: Bacterial or viral infections can damage the ear and potentially lead to sudden deafness.
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Head Trauma: A blow to the head, perhaps from an accident or a sports injury, might disrupt the normal function of the inner ear.
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Autoimmune Diseases: When the body's immune system mistakenly attacks healthy cells in the inner ear, it can result in hearing loss.
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Medications: Some drugs used to treat cancer or severe infections can have side effects that impact hearing.
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Blood Circulation Problems: If blood isn't flowing properly to the ear, it can cause damage to the delicate structures responsible for hearing.
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Neurological Disorders: Conditions like multiple sclerosis can also play a role in sudden deafness.
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Inner Ear Disorders: Ménière’s disease, for example, can lead to sudden and unpredictable hearing changes.
Most of these causes come with certain medical signs or symptoms that can help doctors arrive at a correct diagnosis. And it matters whether the hearing loss is in one or both ears. If it's just one ear affected, doctors will need to rule out tumors on the auditory nerve as a possible cause. Autoimmune diseases, on the other hand, can cause SSHL in either one or both ears.
How is Sudden Deafness Diagnosed?
The first step is to rule out conductive hearing loss. That's the kind of hearing loss caused by a physical obstruction in the ear, like fluid build-up or earwax. If there's no obvious cause after a basic examination, the doctor will typically perform a test called pure tone audiometry within a few days of the symptoms starting. This test measures how loud different sound frequencies or pitches need to be before you can hear them. One sign of SSHL is a loss of at least 30 decibels (decibels measure sound intensity) across three connected frequencies within 72 hours. This would make normal conversation sound as faint as a whisper. Sometimes, patients have more subtle changes in their hearing, and additional tests might be needed for an accurate diagnosis.
If you're diagnosed with sudden deafness, your doctor will likely order more tests to figure out the root cause. These could include blood tests to check for markers of various diseases, imaging tests like magnetic resonance imaging (MRI) to get a detailed look at the inner ear structures, and balance tests since inner ear problems can often affect balance too.
How is Sudden Deafness Treated?
The go-to treatment for sudden deafness, especially when the cause is unknown, is corticosteroids, which is used to treat many disorders and work by reducing inflammation, minimizing swelling, and helping the body's natural defenses kick in. In the past, steroids were given as pills. But in 2011, a clinical trial funded by the NIDCD showed that injecting steroids directly through the eardrum (intratympanic injection) was just as effective as taking them orally. Nowadays, many clinics offer this option. It's a great alternative for those who can't take oral steroids due to other health issues or who want to avoid potential side effects. It's vital to start steroid treatment as soon as possible for the best results. Sometimes, doctors might even recommend starting treatment before all the test results are back. Delaying treatment for more than two to four weeks makes it much less likely that any permanent hearing loss can be reversed or reduced.
Depending on the underlying cause of SSHL, additional treatments might be necessary. If an infection is to blame, antibiotics will be prescribed. If certain medications are causing the problem, your doctor will advise switching to a different drug. And if an autoimmune condition is the culprit, drugs that suppress the immune system might be recommended. For those with severe hearing loss that doesn't respond to treatment or affects both ears, hearing aids (to amplify sound) or cochlear implants (to directly stimulate the auditory pathways to the brain) could be the next step.
Remember, if you suspect sudden deafness, don't wait. Seek medical attention immediately to give yourself the best chance of recovering your precious hearing.
