Recovering from Sudden Hearing Loss
Dr. Liz Tusler Meyer
At Audiology Associates, many of our patients ask us about trying to recover from hearing loss. Most hearing loss is irreversible, but there is one kind of hearing loss that sometimes can improve. Have you ever heard of, “sudden hearing loss” or “sudden sensorineural hearing loss”? This is a somewhat uncommon condition that varies greatly on severity, time course, and the frequency spectrum of the hearing loss. A commonly used criterion to qualify for this diagnosis is a sensorineural hearing loss of greater than 30 dB over three contiguous pure-tone frequencies occurring within a three-day period. What can cause this? The hearing system is very sensitive to changes in blood oxygen levels and changes in the nutrients in the blood. Major changes in the blood supply can cause sudden hearing loss. I once had a patient who had sudden hearing loss following a cruise when they took up rock climbing on a cruise. The significant change in their blood oxygen levels from the extreme exercise likely caused the hearing loss, a very strange occurrence! Often, sudden hearing loss comes without any warning or any other significant issues.
The vast majority of cases of sudden hearing loss are unilateral, and the prognosis for some recovery of hearing is good. Only about 10 to 15 percent of people with SSHL will ever know what actually caused their loss. That may be because there are many possible etiologies, including:
- Labyrinthine viral infection
Labyrinthine vascular compromise
Intra-cochlear membrane ruptures
Immune-mediated inner-ear disease
- Respiratory infections
Infectious diseases such as Lyme disease
Sudden sensorineural hearing loss most often occurs a week or so after a person has experienced a viral or bacterial infection, such as a head cold or the flu. When they see their family physician, it is often mistakenly confused with a common middle-ear infection and treated thusly. However, if the hearing loss is one sided and/or accompanied by tinnitus or vertigo, you should see an audiologist or otologist immediately. Although spontaneous recovery does occur, SSHL is a medical emergency and requires immediate medical evaluation. Estimates of the annual incidence of sudden sensorineural hearing loss range from five to 20 cases per 100,000 people. Many cases likely go unreported, and so the incidence may be higher.
Early treatment for SSHL can save your hearing, so it’s important to see a hearing healthcare professional for immediate evaluation.
Evaluation should include a careful history and physical examination, including diagnostic audiometric testing. Due to the elusive causes of SSHL, treatment options have been somewhat controversial. No single treatment has been shown to be unequivocally effective in treating patients with SSHL. However, the anti-inflammatory properties of corticosteroids make them a common treatment option. Most people do recover at least some of the hearing lost. For those patients with resultant permanent hearing loss, hearing technologies such as hearing aids and implantable devices can often help.