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Sudden Hearing Loss

Quick treatment is crucial for this often-mysterious condition

If you woke up one morning and found you couldn't see out of one eye, odds are you'd call the eye doctor immediately — or even go to the emergency room. Unfortunately, observes R. Mark Wiet, MD, an ear, nose and throat specialist at Rush University Medical Center, we don't tend to treat our ears with the same sense of urgency.

"When sudden hearing loss occurs," Wiet says, "people often think it's due to earwax and tend not to get it checked out right away."

But sudden sensorineural hearing loss — also called sudden hearing loss or sudden deafness — is far more serious than an ear plugged with wax, and immediate treatment is crucial. Sensorineural hearing loss occurs when the inner ear or nerve pathways connecting the inner ear to the brain are damaged.

"If a patient who has experienced sudden hearing loss comes in to our office within seven days, we can probably preserve their hearing," Wiet explains. "If they come in after that, they are much more likely to have permanent hearing loss."

Recognizing the problem

If your hearing has suddenly diminished, then, how do you know whether your ear is plugged or if it's something more serious requiring immediate medical attention?

"People with earwax buildup feel like they have a cork in their ear, and that sensation can be accompanied by a ringing in the ears called tinnitus and dizziness," Wiet says. 

Unlike the slow buildup of earwax, sudden hearing loss occurs very rapidly — over a period of a few hours or, at the most, a few days. It usually strikes adults between 30 and 60 years old (though it can happen to anyone), and most people with the condition experience loss in only one ear.

Many causes, many treatments

There are dozens of possible causes, so when a patient comes in for treatment, Wiet and his colleagues conduct a detailed examination in an effort to discover what's behind the sudden loss of hearing.

Top causes of sudden hearing loss include the following:

  • Ongoing exposure to loud music
  • Illnesses such as mumps, meningitis, multiple sclerosis or measles
  • Head trauma
  • Drugs such as aspirin, cisplatin and quinine, or the antibiotics streptomycin and gentamcin
  • Genetics (it can be passed along from generation to generation)

Sometimes the problem proves to be high platelet count or a blockage in the cochlear artery, which carries blood from the heart to the ear. Other potential causes include overuse of opiate drugs and autoimmune inner ear disease, in which the body's immune system attacks part of the ear.

To determine the cause of your sudden hearing loss, the doctor will ask these questions

  • When did you first notice hearing loss? Was it sudden or gradual?
  • Does it affect one ear or both ears?
  • Do you have a history of ear infection?
  • Do you have a family history of hearing loss?
  • Have you been sick recently? What is your history of illnesses?
  • Have you been exposed to loud noises at home or at work?
  • Have you had any head injuries?

When physicians identify one of these diseases, they are able to treat the hearing loss by targeting the underlying condition.

In the vast majority of cases, though, sudden hearing loss is idiopathic, meaning doctors can't determine its cause. In such instances, they often prescribe oral steroids, which have been shown to help patients recover from unexplained sudden hearing loss.

For some patients who have medical conditions such as osteoporosis or diabetes that can make taking steroids inadvisable, physicians at Rush inject the medication directly into the ear's tympanic membrane to limit potential effects on the rest of the body.

Unraveling the mystery

In the hopes of eventually targeting treatments even more precisely, researchers are trying to unearth the reason behind most idiopathic sudden hearing loss. They suspect it may result from a virus that attacks the inner ear, Wiet says, affecting the cochlea (a spiral-shaped cavity of the inner ear that contains nerve endings essential for hearing) and causing the ear not to work.

Unlike the slow buildup of earwax, sudden hearing loss occurs very rapidly — over a period of a few hours or, at the most, a few days. 

"This can be a confusing diagnosis because on occasion patients will see a doctor with complaints of only new ear pressure or just tinnitus, and they are not complaining of hearing loss," says Wiet. "So there can be a delay in obtaining the appropriate tests, and providing them with appropriate treatment. Time is of the essence with this diagnosis.

"Our goal is that if anyone calls our office saying they've experienced new, sudden hearing loss, we get them an appointment and a hearing test within seven days," he adds.

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