Maybe you have a cold for a few days, then you wake up and notice you can’t hear out of one ear. Or you realize you can’t hear when you’re talking on the phone. Possibly, you hear a loud pop and then notice ringing in your ear. You may also experience dizziness, vertigo, tinnitus (ringing in the ears) or a feeling of pressure in your ear as if it’s clogged.
These could be the symptoms you experience with sudden deafness, or sudden sensorineural hearing loss (SSHL). It’s not that common—it only affects one to six of 5,000 people in the United States, according to Helena Wichova, MD, a neurotologist with Banner – University Medicine. But it’s crucial to be aware of it because getting treatment quickly improves your odds of restoring your hearing.
What causes SSHL?
It’s usually not clear what triggers it. Experts suspect it could be a viral infection that causes inflammation in the inner ear. Sometimes, you could lose your hearing suddenly for reasons other than SSHL. For example, it could be a middle ear infection, an autoimmune disease, allergies or earwax blocking your eardrum.
Rarely, a slow-growing, non-cancerous brain tumor (acoustic neuroma or vestibular schwannoma) could cause sudden hearing loss. So, your doctor may recommend you have an MRI to rule that out.
Does it typically affect one or both ears?
Most commonly, it only affects one ear. It only affects both ears 1 to 2% of the time.
How much hearing loss does SSHL usually cause?
“It really varies,” Dr. Wichova said. It could range from mild to severe, and some people lose their hearing completely. It can affect different pitches, so some people struggle more to hear men, while others have more trouble hearing women.
A diagnosis of SSHL means your hearing has dropped at least 30 decibels over three consecutive frequencies, and it happened in 72 hours (about 3 days) or less. “For most people, that means normal conversations sound like a whisper,” Dr. Wichova said.
Some people also have trouble understanding speech clarity—they can hear the sounds someone makes when they are speaking, but they can’t quite make out the words.
What should you do if you notice a sudden drop in your hearing?
You should seek medical care right away. “Prompt evaluation is essential to try to rescue hearing. There is good data that treatment which occurs ideally within 72 hours or in up to one week provides much better hearing recovery,” Dr. Wichova said.
Most people start with their primary care doctor or a visit to an urgent care center. If they don’t find any other cause for the hearing loss, such as ear infections or blockage from ear wax, they will most likely refer you for a hearing test, called an audiogram, and an appointment with an ear, nose and throat specialist (ENT). “The only way to understand the type and extent of hearing loss is with an audiogram, so this should be done early,” Dr. Wichova said.
How can sudden deafness be treated?
Steroids are usually the first line of treatment. Most ENTs will start with a prednisone prescription you can take by mouth. “Even though we don’t fully understand what causes SSHL, multiple studies have found that steroids work very well for recovering hearing,” Dr. Wichova said. They may work by reducing inner ear inflammation.
Some people can’t take oral steroids or experience side effects—they aren’t recommended for people with diabetes, glaucoma, osteoporosis and some other health conditions. In those cases, intratympanic steroid injections could work. They might be an option for people who aren’t seeing any improvement with oral steroids, too.
In this procedure, your ENT will numb your eardrum and create a microscopic hole in it, then inject a steroid solution through the hole. You’ll probably need an injection weekly for three to four weeks. “This procedure is done routinely in ENT offices, and most people tolerate it well,” Dr. Wichova said.
Hyperbaric oxygen therapy is another option. With these treatments, you breathe pure oxygen that’s under pressure, so your lungs take in a lot more oxygen than they normally do. This extra oxygen helps promote healing in your body.
How likely is it that your hearing will come back?
About two-thirds of people get some of their hearing back with treatment, usually within the first four to six weeks. “In rare cases, hearing recovery can take up to one year,” Dr. Wichova said.
If you don’t fully recover your hearing, options like conventional hearing aids or contralateral routing of signals (CROS) hearing aids can help. CROS hearing aids are designed for people with hearing loss in only one ear. They take the sound from the ear that isn’t hearing well and send it to your other ear so you can access all the sounds around you. If hearing aids aren’t helping, you might be able to get a cochlear implant to help restore some of your hearing.
The bottom line
Sudden hearing loss is uncommon, but if you experience it, you should seek medical care right away. Treating it within the first days increases your odds of restoring your hearing. If you would like to connect with a health care professional who can diagnose and treat hearing problems, reach out to Banner Health.