What Is Sudden Hearing Loss?

Sudden hearing loss, or sudden deafness, is exactly what it sounds like: loss or partial loss of the ability to hear within a very short time. It may happen all at once or gradually over several hours or days. Most often, it affects just one ear (unilateral deafness), but about 2% of the time it’s bilateral (affecting both ears).

A man undergoing a hearing test
Maica / Getty Images

Clinically known as “sudden sensorineural (meaning inner ear) hearing loss” or SSNHL, the condition impacts about 0.1% of people in the United States each year, mostly those over 40. Sudden sensorineural hearlng loss may be due to injury, disease, or problems with the ear’s structure. It requires immediate attention to identify the cause and prevent long-term deafness. 

Symptoms

For many people, the first symptom of sudden hearing loss is a "pop" followed immediately by the sensation of being unable to hear. Frequently there's a feeling of fullness in the affected ear. In other cases, there's no such warning: The person first notices a problem when they awake from sleep.

SSNHL can result in a total loss of hearing, an inability to hear low or high frequencies, or difficulty understanding what people are saying. Up to 90% of people with sudden hearing loss in one ear or both ears suffer from tinnitus, or ringing in the ear. 

Because of the ear’s role in balance, sudden deafness may be accompanied by vestibular disorders—problems related to the inner ear that affect coordination or movement. These include:

Causes and Risk Factors

Around 90% of cases of sudden sensorineural hearing loss cases are idiopathic, which means there's no clear cause. Infection is considered the most common identifiable cause (13% of cases).

In addition to infection, SSNHL may be a result of autoimmune diseases, trauma, vascular disorders, neoplasm (tumors or other growths), metabolic diseases, reactions to medications, ear problems, or neurological disorders.

Conditions That May Cause Sudden Deafness
Autoimmune disease -Behcet’s disease
-Cogan’s syndrome
-Lupus
-Other autoimmune inner ear diseases
Infections -Meningitis
-HIV
-Lyme disease
-Mumps
-Syphilis
-Toxoplasmosis (common parasite infections)
Vascular disorders -Heart bypass
-Stroke
-Sickle cell disease
Neoplasm -Vestibular tumor
-Brain tumors
Neurologic conditions -Migraine
-Multiple sclerosis
Ear disease/
disorder
-Meniere’s disease (inner ear disease)
-Otosclerosis (abnormal bone growth in the middle ear)
-Enlarged ear canal
Trauma -Concussion
-Dental procedure/surgery
-Tear in tissue between middle/
inner ear
-Barotrauma (caused by changes in air pressure like when flying) 
-Skull fracture
Metabolic disease -Diabetes mellitus
-Hypothyroidism

Hearing loss can also be a side effect of some medications, including: antibiotics such as Garamycin (gentamicin), which is used to treat several types of bacterial infections; Lasix (furosemide) a diuretic that treats water retention and swelling; chemotherapy drugs; non-steroidal anti-inflammatories; and salicylates (found in pain killers).

Diagnosis

If you experience a sudden loss of hearing, your doctor will first do a medical history and ask about your symptoms. They will then look inside the affected ear to check for obstructions, inflammation, fluid, or wax build-up. 

Next you'll likely undergo a general hearing test in which the doctor may cover your ears one at a time and ask you to repeat words that are whispered. They also may strike a tuning fork near your ear to see if you can detect the tone it emits.

If these tests show hearing loss, you likely will be referred an audiologist (a doctor who specialies in hearing issues) for further tests:

  • Auditory brainstem response (ABR): Electrodes will be placed around your head to measure brain activity while you rest or sleep.
  • Otoacoustic emissions (OAE): A small probe is placed in your ear to measure how the cochlea is functioning.
  • Pure-Tone testing: You’ll wear headphones into which sounds at various volumes, pitches, or frequencies are played and asked to identify when and if you hear them.

These tests help determine how loud a sound needs to be before you can hear it. Sound is measured in decibels (dB). You’ll be diagnosed with SSNHL if you cannot hear a sound below 30dB.

You may need to undergo additional tests to determine a cause for your sudden sensorineural hearing loss, depending on your medical history and other symptoms. A magnetic resonance imaging (MRI) scan, for instance, might be ordered if there’s a reason to suspect tumors. Blood tests can help to confirm or rule out infections, metabolic disorders, or autoimmune disease. 

SSNHL is rare in infants and young children, but if you suspect your little one is having trouble hearing, seek immediate treatment. Hearing loss can have a significant impact speech, language, and cognitive development.

Treatment

In 45% to 65% of people with idiopathic SSNHL, hearing returns within a few days with no treatment.

When needed, the first line of treatment is usually corticosteroids, which reduce inflammation and swelling in the inner ear. Typically, a course of oral steroids such as prednisone or methylprednisolone is prescribed.

Studies have shown that injecting steroids directly into the middle ear is also an effective way to treat SSNHL. These intratympanic injections may be preferable if you're concerned about side effects associated with oral corticosteroids such as hypertension, gastritis, or sleep disruptions.

If idiopathic SSNHL doesn't improve with steroids alone, a doctor may also recommend hyperbaric oxygenation (HBO) therapy. With this course of treatment, you might be placed in a hyperbaric chamber and treated with air compression, made to breathe 100% oxygen through a mask, and undergo a decompression session. According to research, HBO may work by reducing inflammation or because they support healthy function of the cochlea and ear structures, which require a high supply of oxygen.

If your hearing loss is associated with an infection, you will be prescribed antibiotics. In cases where SSNHLis related to an autoimmune disease, you may be placed on immunosuppressant drugs to manage your symptoms.

When SSNHL is related to a reaction to a medication, your doctor will likely have you switch to a different drug.

Coping

If hearing doesn’t return within two to three months, deafness is likely to be permanent. In those instances, support devices may be beneficial. Today’s hearing aids offer a wide range of options to amplify sound or stimulate the inner ear.

Some people with severe hearing loss are candidates for cochlear implants, devices that replace the three small bones of the middle ear to enable the deaf and hard of hearing to hear sound.

Modern technology has also made it a little easier to adapt to sudden hearing loss. Captioning on movies, television, and even YouTube videos allow you to read words that you might miss. Special teletypewriting devices that provide text communication via telephone lines (TTYs) have been around for decades to help deaf and hard-of-hearing people communicate by phone. However, texting and emailing has greatly reduced the need for TTYs. Movie theaters are often equipped with portable captioning devices so you can follow the dialogue of the latest blockbuster.

Research shows that peer-support groups are often an important way to manage stress and adapt to life with hearing loss.Talk to your doctor about local groups and be open about sadness or depression so you can get help and avoid having those feelings affect your quality of life.

A Word from Verywell

Of course, support devices have limitations and it's not unusual to feel a sense of sadness following hearing loss. Learning to navigate the world with reduced hearing, not being able to enjoy music or everyday conversation in the same way as before, and continual discomfort due to lingering tinnitus can be extremely frustrating.

It’s believed that many cases of sudden sensorineural hearing loss may actually go undiagnosed because people dismiss problems with hearing as just “getting old,” ear wax build-up, or other problems they think will go away on their own or can’t be helped. In truth, hearing loss should be evaluated as soon as possible. Getting timely intervention can help you prevent long-term problems or, possibly, reveal a serious medical condition. Acting right away may not only improve your hearing, it may also boost your overall health.

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