Have you experienced a sudden hearing loss in one ear that you attributed to earwax buildup or fluid buildup? Well, you need to have your ears checked because you might be dealing with a serious medical condition called Sudden Sensorineural Hearing Loss or SSHL.
Most of the time, hearing loss has a very gradual onset and it may take months or even years before you start noticing it affecting your communication abilities. However, in some cases, hearing loss can come in an instant. Most people mistakenly assume that these sudden cases of hearing loss are caused by just a buildup of ear wax inside of their ear.
That being said, there is also a common belief that the best way to restore your hearing is to actually dig out that ear wax with a Q-tip or pour some peroxide in there and flush it out. But what if we told you that in some cases a sudden hearing loss like this is actually a medical emergency and requires immediate medical attention.
Understanding SSHL
SSHL is a medical condition that results in a significant decline in your hearing ability that happens almost instantly. SSHL is characterized by a 30-decimal drop in hearing at three adjacent frequencies that are tested and these happen relatively quickly, usually affecting one ear.
To completely understand what a sudden sensorineural hearing loss is, we need to discuss the basic parts of the ear. It is divided into three sections – the outer ear, the middle ear, and the inner ear.
The outer ear consists of the pinna and the ear canal. The middle ear consists of the eardrum, the ossicles (the middle ear bones), the middle ear space, and the Eustachian tube. The inner ear consists of the cochlea (our hearing organ), the vestibular system (the body’s balance system) and the auditory nerve that sends sound information to our brain.
Sound passes through the ear canal and vibrates the eardrum. That vibration moves through the three ossicles to the cochlea, where that sound is converted into a neural signal that is sent up that auditory nerve to the brain. A sensorineural hearing loss occurs when there’s damage to the cochlea or the auditory nerve. This hearing loss is most often permanent, meaning it will not return to normal with medication or surgical intervention.
With a sudden sensorineural hearing loss, there is often damage to the cochlea or the auditory nerve that occurs rapidly. Meanwhile, conductive hearing loss occurs when sound is blocked somewhere in the outer ear or the middle ear – which prevents sound from reaching the cochlea. Quite confusing, right?
This is why it’s so difficult to self-diagnose if you are experiencing a conductive hearing loss or sudden sensorineural hearing loss. The thing about sudden sensorineural hearing loss is that it is in fact considered a medical emergency, which means you should seek out medical treatment as fast as humanly possible.
You need to schedule an appointment with an ear, nose, and throat physician (otherwise known as the otolaryngologist) or an otologist who specializes in the ears. Appropriate diagnosis and immediate medical treatment are critical if you want a shot at getting your hearing back.
SSHL Misdiagnosis
Sometimes medical professionals who are not ear specialists will misdiagnose sudden sensorineural hearing loss assuming that it’s just caused by congestion in the middle ear space or fluid buildup. If this happens, you may not receive the appropriate treatment in a timely manner, which means you might not get your hearing back.
To appropriately diagnose your hearing loss, an audiologist or physician will take a look inside of your ears to determine if there’s any kind of a blockage. If there’s none, they will continue with a comprehensive hearing evaluation where they will determine the type of your hearing loss and the severity of your hearing loss. This test should include pure tone, ear and bone conduction, speech testing, tympanometry and even acoustic reflexes. Your ENT or otologist may also order a CT scan or an MRI just to ensure that there’s no tumor growing inside of your brain or on your auditory nerve which may be causing the sudden hearing loss. There may also be some additional testing that your doctor will have you go through just to rule out any other possible causes of your sudden hearing loss.
Causes of SSHL
Most cases of sudden sensorineural hearing loss are idiopathic which means that there’s no known cause even after a full workup is completed. The most common known causes are viral infections and circulatory issues like lack of blood flow to the cochlea.
Some additional known causes of sudden sensorineural hearing loss include bacterial infections, autoimmune disorders, traumatic injuries, vascular disorders like a blood clot, acoustic neuromas (otherwise known as tumors), metabolic conditions like diabetes, neurologic conditions like multiple sclerosis, chemical agents like chemotherapy drugs or other medications
or otologic conditions such as Meniere’s disease or Enlarged Vestibular Aqueduct Syndrome.
Treating SSHL
The sooner you seek treatment for this condition, the better. The earlier the treatment or intervention, the more likely you are to receive partial or complete restoration of hearing. Sometimes restoration of hearing can happen spontaneously in the first two weeks of occurrence, but in most cases, if you go two to three months, you’re most probably not going to be getting that hearing back.
When it comes to treatment, oral steroids are probably the most common treatment method out there for sudden sensorineural hearing loss. After you complete the entire regimen of that prescription, you should have your hearing tested again to see if there’s any recovery.
If there’s limited to no recovery, you may actually receive trans-tympanic injection of steroids. For this procedure, your physician will use a needle to inject the steroid through your eardrum and into your middle ear space. These injections concentrate the steroid to where it can be absorbed by your cochlea, which may reduce side effects compared to oral steroids.
If your hearing still does not return to normal with these medical treatments, then you may have to start considering hearing aids, cross devices, bone-anchored hearing aids, or even a cochlear implant.
Sudden hearing loss is no joke. So if you notice a significant drop in your hearing in one or both of your ears, do not just assume that it’s earwax or fluid build up. You need to get in and see a medical professional immediately so you can get an accurate diagnosis and treatment as soon as possible so you can have the best shot in restoring your hearing.
