Ask the Audiologist

Sudden Hearing Loss (article from local paper)

Article by Solveig Ingersoll, M.A., CCC

What do a weight lifter, a scuba diver, and an airline passenger have in common with someone with high cholesterol levels? They all are candidates for sudden hearing loss.

"Robert" (not his real name) woke up one morning and noticed that he was dizzy and couldn't hear out of his right ear. He felt fine otherwise and couldn't imagine what was wrong. A fitness fanatic, Robert jogged several miles every day. Just yesterday, he had set a new personal weight lifting record. In spite of his dizziness, he went to work, but his friends convinced him to call an ear doctor. The doctor insisted that Robert come for an appointment that same day, and after many tests, scheduled Robert for surgery the next morning. Robert had all the symptoms of a leak in his inner ear. The doctor would try to patch the leak before permanent damage was done.

Sudden hearing loss syndrome is a sudden decrease or loss of hearing in one or both ears. It may be accompanied by static or ringing in the ears and/or dizziness up to 12 hours before the time the hearing loss occurs.

There are many possible contributory causes: sudden pressure changes in the ear during airplane travel or scuba diving, unusual physical exertion or strain, previous ear surgery, recent upper respiratory infection, drugs such as birth control pills and ototoxic antibiotics, sudden or prolonged loud noise exposure, and smoking. In many cases, the exact cause is unknown and the underlying pathology is suspected to be due to problems with inner ear circulation.

The initial assessment of the patient who reports sudden hearing loss will include the following: Medical history and ear examination, blood tests and audiological evaluation. Depending on the outcome of those tests, further tests may be recommended such as an auditory brainstem response analysis or a magnetic resonance imaging scan.

The history may alert the doctor to situations which may have caused the loss, such as an upper respiratory infection, air travel, scuba diving, smoking, birth control pills, ototoxic medications or existing medical disorders.

The ear examination will show abnormalities such as excessive wax in the outer ear canal, infection or fluid in the middle ear, or perforation of the eardrum.

Blood tests may show elevated levels of triglycerides and/or cholesterol, syphilis, infection, diabetes, thyroid or kidney disorders, or auto immune disease.

An audiological evaluation will determine the degree, type and location of the hearing loss, whether it is a loss of the middle ear, inner ear or auditory nerve. In addition, testing will determine the ability to understand speech. Immittance testing will assess the physical status of the eardrum and middle ear muscle reflexes. Special tests, such as the auditory brainstem response analysis which measures the brain's responses to sound, can serve to confirm the diagnoses or at least to rule out some possible causes for the symptoms.

Treatment of sudden hearing loss varies, depending on the suspected cause. The patient may be given medicine to increase circulation of the inner ear or to reduce excessive fluid buildup in the middle or inner ear. Carbogen therapy, which increases the amount of oxygen to the inner ear, may be started if there is a suspected circulation problem. A specific regimen is indicated if there is fluid buildup in the middle or inner ear and surgery may be required for an inner ear tumor or a leak of inner ear fluid. The patient may be advised to stop the use of birth control pills, smoking, drugs, alcohol, or caffeine, or to restrict the amount of strenuous activity, as well as to watch his intake of fats and cholesterol.

In summary, anyone who notices any sudden loss in hearing, regardless if there are any accompanying symptoms (fullness in the ears, ringing or dizziness), should be seen by an ear, nose and throat doctor within 24-48 hours. Recovery of the hearing loss depends not only upon the early diagnosis, but also on the early initiation of treatment.

Robert experienced rapid recovery of his hearing after the operation. He was advised to avoid strenuous exercise, especially excessive straining. Robert was smart to go to his doctor immediately after experiencing his hearing loss. Many people try to ignore the symptoms for several days before asking for help. By then it may be too late and their loss becomes permanent.