Sudden hearing loss (SHL) is defined as a hearing loss occurring over a period of fewer than 3 days. It is most commonly reported as hearing loss in one ear upon awakening in the morning, however, could be noticed over a period of hours or days and could be present in both ears. Tinnitus is reported in 70% of SHL cases, while vertigo is present in 50% of cases. The majority of patients reporting sudden hearing loss are over 40 years old and the incidence increases with age.
The treatment for sudden hearing loss is urgent. The prognosis of recovery often depends on early treatment. The recommended evidence-based practice involves an immediate collaboration of otologists (ENT), primary care or emergency room physician, and audiologist.
The treatment of idiopathic SHL is controversial. Possible treatment methods include; the use of systemic steroids, antiviral medications, vasodilators, no treatment, and carbogen therapy. High doses of oral steroids are the most widely accepted form of treatment. If a favorable response to steroids is noted, therapy is continued for an additional 2 weeks, after which they are tapered slowly.
Steroid injections (dexamethasone or methylprednisolone) are currently used in patients where oral steroids are not recommended or in patients who fail to show improvement with oral steroids. In this procedure, steroids are injected into the middle ear. It is reported that 40-70% of people with SHL will have spontaneous recovery. If spontaneous recovery occurs, it is usually within the first 2 weeks. The chances of full recovery decrease with the severity of hearing loss and the presence of vertigo.
In the past, rehabilitation of patients with unilateral sudden hearing loss was limited and had mixed satisfaction reports. For this reason, most patients were left unaided. Today, technology has improved and rehabilitation is received with more success. Should you or someone you know experience sudden hearing loss, seek immediate medical treatment with your audiologist, PCP, and ENT. Once medical management is chosen, continue to consult your audiologist for possible rehabilitation options.