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One of the most confusing and contentious unsolved mysteries in otolaryngology, sudden deafness is a rapid loss of hearing. Most patients have reported onset of hearing loss within minutes to several hours and about one-third of patients will wake with the loss; others may find out the problem on trying to use the telephone, or describing a brief period of fluctuating hearing before the loss. Auditory nerve damage due to certain drugs such as Gentamycin, streptomycin, chloroquin, etc.
Identical experiences like loud noise can cause hearing loss in one person and leave another relatively unaffected. A sulfur-containing fatty acid, an alpha-lipoic acid helps to generate the energy that keeps us alive and working. The study has shown that the groups given the magnesium supplement were not as likely to experience permanent hearing damage as those given a placebo. Vitamin D deficiency has also been associated with otosclerosis (abnormal bone growth in the middle ear), presbycusis, unexplained and bilateral cochlear deafness, and sensorineural hearing loss.
Always wear ear protection (disposable plugs or ear­phone-style headset) when using loud appliances for example power tools or lawn mowers; and when you know you will be exposed to sudden loud noises, such as when shooting a gun. As mentioned above, Sudden Hearing Loss or sudden sensorineural hearing loss is a type of hearing loss where there is a hearing reduction of more than 30 Decibel, over a three contagious frequencies, which occurs over a time period of 72 hours or less. People of all ages can be affected to such a kind of hearing loss all of a sudden; however it is mostly seen in adults from the age groups 30 to 60 years of age.
Sudden hearing loss or the sudden deafness is also called as sudden sensorineural hearing loss (SSHL) which is caused by damage in the vestibulocochlear nerve, the inner ear or the central processing centers of brain. There are some rational approaches in the treatments available for sudden hearing loss which must be given a thought. It is obvious that the first step of diagnosis of sudden hearing loss begins from documenting the recent reduction in hearing or the recent level of hearing loss, with the help of an audiogram. Now let us look for some of the special tests particularly advised for checking the status of a sudden hearing loss for further treatments or precautions. MRI Brain Testing: There can be certain conditions related to sudden hearing loss or the sudden sensorineural hearing loss, like the acoustic neuroma or the tumors, strokes etc.
Audiometric Testing: There are some kind of audiometric testing for sudden hearing loss, which are done with the help of an audiometer. It is now obvious that when a condition of sudden hearing loss is diagnosed; then the prime most thing of consideration is to look after the possible treatments available for treating the sudden hearing loss condition in the patient. Treatments via Rheologic Agents: Reducing the viscocity of blood can help in an improved oxygen delivery and a proper flow of blood to the cochlea. Vasodialators For Treating Sudden Hearing Loss: Vasodialators are the agents which help in enhancing the blood flow to the cochlea. Anti-Inflammatory Treatments Via Steroids And Corticosteroids: Various studies and trials have found that steroids are useful in treating sudden hearing loss to some extent and that oral steroids as well as steroid injections can be given to the affected person while treating the condition. Anti-Viral Treatments: There are some known anti-viral agents which are proposed in treating sudden hearing loss.
Treatments via Triiodobenzoic Acid Derivatives: There are some agents which are thought to help in maintaining the endocochlear potential.
Hyperbaric Oxygen Therapy For Sudden Hearing Loss: It is also regarded that improving the oxygen tension in the hyperbaric chamber, helps in treating the sudden hearing loss. Now, apart from all these diagnosis and treatment procedures; one must be very cautious on keeping self safe from any unwanted condition and prevent self from the sudden hearing loss in a better way.
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See Introduction by guest-editor Maurice Miller, PhD, for other articles in this special issue.
Sudden Sensorineural Hearing Loss (SSNHL) is one of the few sensorineural losses known to be reversible.
Sudden Sensorineural Hearing Loss (SSNHL) is one of the few sensorineural losses known to be reversible in some cases. In a recent 10-year retrospective study2 of 318 patients, 88% had little or no pre-existing hearing loss on the contralateral side and, as a result, were not previously under the care of an audiologist or otolaryngologist.
Once referred to an otolaryngologist, such cases may benefit from the application of steroids (typically Prednisone) for several weeks. Even though outcome is variable, the 10-year study noted above showed a significant benefit to the use of steroids for SSNHL.2 Because of the possibility of improved outcome with steroids, and the narrow window of opportunity for initiating treatment, SSNHL should be considered an emergency of the ear. Vascular insufficiencies were proposed by several authors, based primarily on the brief time course of the onset, as if blood supply to the cochlea had been interrupted. Several authors have shown an association of SSNHL with active viral upper respiratory illness. On the other hand, it is not necessary for infection of the cochlea itself to occur in order to provide a viral-based mechanism for SSNHL. Although corticosteroids are known to cause a host of side-effects, the vast majority of these are dose-related. A unilateral loss of practically any audiogram type can develop suddenly and present in the audiology clinic or practice. The low frequency category was given special consideration since low frequency sensorineural loss can be a symptom of Meniere’s syndrome. On the other hand, when sudden, unilateral sensorineural loss first presents, it may be impossible to know if it is SSNHL or Meniere’s syndrome. Figure 1 shows the result of audiologic evaluations done when the patient first presented and then 1 month later after receiving a standard 3-week course of steroids. Some studies have been undertaken to evaluate the benefit of antiviral drugs in combination with steroids for treatment of SSNHL. There is no question that early diagnosis and treatment are needed in order to get the best outcome for patients with SSNHL. Chris Halpin, PhD, is a clinical associate in audiology at the Massachusetts Eye and Ear Infirmary in Boston, and is assistant professor of Otology and Laryngology at Harvard Medical School.
If you’ve ever watched action or war movies that feature large bombs or quick explosions with a grenade, you’ll likely notice a common theme. Sudden conductive hearing loss is often caused by impacted wax in the ear canal, fluid buildup, or an infection. The sooner your child receives treatment for SSHL, the better his chances are of regaining his hearing. Stay up to date with the latest news on treatments for sudden hearing loss and tinnitus by visiting frequently.
Having my story out there will hopefully help others fight the battle against sudden hearing loss, or at least help them learn to cope. Losing your hearing is very common in people these days, so I think it`s important to have information like this one!
Sudden hearing loss, also known as sudden sensorineural hearing loss, is a medical emergency that is extremely frightening for the person experiencing it. There have been ongoing debates as to whether Intra-Tympanic Steroid Injections would be the most effective medical intervention in treating Sudden Hearing Loss or if the widely practiced evidence-based medical management of oral steroids would be a safer choice. When seeking the different options for tinnitus treatment, there are a couple of options that one can consider. From the affected individuals, about 10% of have known causes which include infections, circulatory or neurological disorders, trauma, immune disorders or drugs toxic to the ears. The most widely used treatment is high doses of steroids, and some people recover from SSHL, but not others. Lipoic acid has broad range of antioxidant action and thus giving defense against free radicals. A lower dosage of 20 to 50 mg daily is commonly recommended for use as a general antioxidant. Magnesium can be taken in a supplement that includes magnesium, calcium and vitamin D for the most benefit, read below. Deficiency of vitamin D is probably one of the reasons and supplementation should be considered in persons with hearing loss as noted by researchers. Keep the volume low enough that you can easily hear the telephone and other sounds over the music. This is particularly important if you have repeated ear infections and have been treated with antibiotics.


Permanent deafness is a condition in a person's life where he is restricted from hearing completely forever. The diagnosis procedures usually decide about the type of treatment to be undertaken by the patient.
It is first necessary to understand the level of loss a person has suffered or the hearing reduction percentage that has encountered a victim which further would require the treatment. These audiograms are actually the graphical presentation of the audible threshold for the standardized frequencies that are measured by an audiometer. Pure tone and speech audiometry, tympanometry, otoacoustic emissions (OAE) etc are some of the known audiometric testing. Accordingly there are special tests for the special cases that lead to sudden hearing loss. Any treatment begins with the thorough consultation and mutual understanding between the doctor and the patient. This reduction in blood viscocity can be done with the use of low molecular weight dextrans or anticoagulants like Heparin.
However, it is also found that oral steroid doses have a lot of side effects and the steroid injections are pretty costly. Acyclovir and Amantadine are two such names, but with limited use in the treatment procedure. Angiographic contrast agent like the Diatrizoate meglumine was found to have an effect on sudden hearing loss and is thus considered as the most commonly used derivative of triiodobenzoic acid. Treatments via diurectics and certain minerals and vitamins can be effective but there are no proper evidences or explanation on the same. It is needed to keep yourself away from the loud noise that can cause the noise-induced sudden hearing loss, keep self safe from any harsh physical trauma which can damage the inner ear and lead to sudden hearing loss, and also be very much sure about the drugs or medicines being taken for illness, have got no side effects like the hearing loss on temporary basis and keeping safe from ear infection & thus restricting the sudden hearing loss caused due to viral infections. In cases where such an outcome is possible, there appears to be a time window of no more than 2-4 weeks from onset of deafness during which treatment must be started to be effective.
The chance to improve hearing with the application of steroids can be very rewarding for an otolaryngologist and audiologist, and this depends upon early diagnosis of the cases where such an outcome is possible. In these cases, the initial symptoms were often a combination of hearing loss and a pronounced “blocked” sensation that frequently led primary care physicians to a mistaken preliminary diagnosis of otitis media. Patients with SSNHL have also been shown to have antibodies to certain viruses.7 Postmortem examination of SSNHL temporal bones have shown atrophy of the organ of Corti, spiral ganglion, and tectorial membrane, with relatively good preservation of spiral ganglion cells.
Adams9 has shown that bio-molecules known as inflammatory cytokines are produced in the cochlea as a response to viral disease in the upper respiratory tract.
Therefore, they are unlikely to occur during the relatively short “burst and taper” treatment used for SSNHL.
In Meniere’s syndrome, fluctuations in low frequency hearing can occur in the same timeframe as in SSNHL. It is prudent to err on the side of treating the potential emergency condition, SSNHL, with a tapering course of oral steroids.
Audiograms taken one month apart showing the reversal of SSNHL after a course of steroid medication. Nearly 40% of steroid-treated cases did not recover at all, or the hearing worsened over the treatment period and these hearing losses remained permanent.
In the retrospective study of Chen et al,2 52 patients declined treatment or had medical contraindications to the steroid therapy. To date, none have shown efficacy above steroid treatment alone.11,12 While steroids themselves are likely to remain the medication of choice for SSNHL, there is an emerging new delivery system which may prove to be beneficial.
Every effort must be made to spread the word about this condition to primary care physicians and other primary care providers so they will make prompt referrals to audiologists and otolaryngologists who can initiate appropriate evaluation and treatment.
Your child might wake up with abrupt hearing loss or he might experience severe hearing loss over the course of a few days. Quite often, a doctor will recommend a course of corticosteroid treatment to reduce the inflammation that can result in damage, particularly if the cause of the hearing loss is not determined. It is ideal for people who need a device that is not visible and one that can facilitate their hearing. The root cause of sudden deafness lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centers of the brain. Most people recover impulsively within a few weeks, but 15% experience progressively worsening symptoms.
If the hearing loss is not severe, some doctors to not recommend any treatment but individuals who suffer from SSHL can be very fearful of the prospect of being permanently deaf in one ear, and this can set up a long treatment options that can be intimidating to the patient and the doctor. They generally work to decrease inflammation, decrease swelling, and help the body to fight illness. The researchers suggest that diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear. Also, it has potential benefits for diabetic neuropathy, and it is proposed that it may help to prevent or repair nerve damage that causes hearing loss.
You should be the only one able to hear your music if you are using a personal stereo unit with headphones. There are certain important reasons that may cause permanent deafness, which may includes damage in the ear or damage in the nerve that serves for transmitting sound to the brain. There are problems which come in to live at certain circumstances which are pretty different from the usual ones. It is found that 60 % of the patients suffer from sudden loss of hearing due to the viral diseases like those caused by influenza type B virus, CMV or Mumps virus, about 1% of the sufferers are those who get in to Sudden Hearing Loss due to vascular disease. Let us discuss on the diagnosis and some of the treatment procedures for sudden hearing loss or sudden sensorineural hearing loss. In order to know the condition, it is required to go for certain diagnosis and tests under expert professionals in a proper manner.
It is very much true that checking the history of a victim for any infectious causes having its roots leading to sudden hearing loss can also help in a great way for diagnosing the condition of hearing loss. Electrolysis, comprehensive metabolic screen test, CT scan for temporal bone and Lyme test are some of the common tests done under special cases for knowing about the condition of hearing reduction. Now coming to the treatments available for SHL, there are no such preferred treatments noted.
Some of the most common agents used for improving the cochlear blood flow, includes Papaverine, Histamine, Procaine, Niacin, Nicotinic acid, Carbogen etc. Two alternative names Famiclovir and Valacyclovir, have come in to the list of consideration for treatment for sudden hearing loss. One study done during 2004 by Narozony; has found that the hyperbaric oxygen therapy comprising of a 100% oxygen at a 250kPa pressure for about 60 minutes in a multi-place hyperbaric chamber along with the high doses of Glucocorticosteroids enhances the treatment results in conventional sudden sensorineural hearing loss.
It is also to be noted that be very much sure to immediately sought treatment for any of the causative diseases or conditions like the vascular or the neural etc.
Further, there is a range of outcomes, including some untreated cases where spontaneous recovery is seen and some treated cases that do not respond at all.
SSNHL is characterized by new-onset unilateral sensorineural hearing loss that develops within 72 hours. Ultimately audiologic evaluation demonstrating elevated bone conduction thresholds and normal tympanometry is needed to establish the correct diagnosis. First, there appears to be a time window of no more than 2-4 weeks from onset of deafness during which treatment must be started to be effective.
In the retrospective study by Chen et al.,2 a large number of flat losses were found (37%), but both high (6%) and low frequency (12%) steeply sloping losses were also seen. In the Chen et al.2 study, low frequency cases were excluded in order to prevent any mixing of the SSNHL and Meniere’s etiologies.
If the the ear goes on to fluctuate and cause vertigo attacks, the Meniere’s diagnosis will eventually become apparent.
Most authorities advocate testing hearing again at 6 months and 1 year after treatment to confirm that recovery is stable and assure that no other problems have arisen in the contralateral ear. In the other 60% of cases, the steroid-treated group improved by an average of 29 dB PTA (500 Hz, 1000 Hz, 2000 Hz and 4000 Hz). This cohort of subjects provides an opportunity to study the natural history of the disorder. Instead of tablets taken orally, the medication can be injected through the anesthetized tympanic membrane and will diffuse through the round window directly into the cochlea.


Rauch, MD, is a surgeon in otolaryngology at Massachusetts Eye and Ear Infirmary and is associate professor of Otology and Laryngology at Harvard Medical School.
Oral steroid treatment for sudden sensorineural hearing loss: a ten year retrospective analysis. The relationship of the herpesvirus family to sudden hearing loss: a prospective clinical study and literature review. Hearing loss in experimental cytomegalovirus infection of the guinea pig inner ear: prevention by systemic immunity.
Dexamethazone inner ear perfusion for the treatment of Meniere’s disease: a prospective, double blind crossover trial. Antiviral treatment of idiopathic sudden sensorineural hearing loss: a prospective, randomized, double-blind clinical trial.
Speech might sound distorted, or your child might have selective low- or high-frequency loss. Sudden sensorineural hearing loss may result from a viral infection, physical trauma, circulatory problems, drugs, or an acoustic neuroma, which is a slow-growing tumor.
However, if the cause of conductive hearing loss is trauma, your child might require surgery or a hearing aid. SSHL is defined as an idiopathic hearing loss of sensorineural origin, greater than 30 dB in three connected frequencies that usually occurs in less than three days and in only one ear. Standard management of sudden deafness consists of removal of the known cause, antibiotics, steroids and inhalation of a mixture of carbon-dioxide and oxygen. Steroid treatment helps to some SSHL patients who also have conditions that affect the immune system, the body’s defense against disease. In the body, just one deficiency can have trickle down affect and makes it very hard to isolate the exact cause of sudden hearing loss, and many other disease process. However there are also conditions in man when all of a sudden there is a 30 decibel reduction in hearing over three contagious frequencies that occurs over 72 hours or even less and when the outside sounds gets unreachable to the ear, or may be a kind of ringing ear or tinnitus is felt inside the ear. There are some unusual circumstance that get a kind of instant or sudden deafness, a kind of ringing ear symptom or tinnitus, which may be mild, moderate or may be severe based on the level of hearing reduction. Studies involving sudden hearing loss have also found that 20% to 60% of the sudden hearing loss resulted from Vertigo. However, there are some possible treatments available for such conditions which are based on rational approaches. Studies have found that carbogen when combined with drugs, works better than the therapeutic drugs for the treatment of sudden hearing loss.
It is very often accompanied by a feeling of fullness and, occasionally, by tinnitus and vertigo.1 Audiologic evaluation establishing a sensory rather than a conductive pathology is critical to the diagnosis. Second, there is a range of outcomes, including some untreated cases where spontaneous recovery is seen and some treated cases that do not respond at all. Gap junctions function as gates between the supporting cells in the cochlea, allowing the proper ions to be transported to maintain the fluid “battery” necessary for normal hearing. In clinical practice, a similar caution is in order, requiring careful follow-up by an otolaryngologist and audiologist to establish a clearer picture of the disease. Bone conduction with masking and word recognition testing are essential in order to evaluate the sensorineural nature of the disorder and the improvement, if any. This was a better outcome than seen in the untreated cases, where a spontaneous improvement mean of 11 dB PTA was seen.
Typically, an audiologist will define it as hearing loss of greater than 30 decibels over three contiguous frequencies that occurs within a three-day time period. By taking less processed sugar in diet, you can low your blood sugar and thus reverse some of the debilitating effects. Sometimes patient might suffer from a kind of hearing loss all of sudden in the morning instantly and some meet with the loss of hearing gradually over some days time. Some of the common causes of sudden hearing loss include the loud noises, physical trauma, certain drugs or medicines, some neurological issues, vascular diseases and some viral diseases or infection. There can be side effects of the treatments available for the sudden hearing loss, but again it is solely up to the patient's agreement while undergoing any treatment procedure for SHL.
These anti-viral agents actually inhibit the Viral DNA polymerase and thus restrict the viral DNA from replicating. Besides this function, gap junctions transport other necessary chemicals and so, if this system is stopped, the result is expected to be a sudden decrease of sensorineural function, and eventual death of hair cells.
Stomach problems are generally only seen during the early phase of treatment when steroid dose is higher, and it can often be avoided by giving the medication with a meal.
As is usually the case, there was also a good number of audiograms (22%) which did not neatly fall into a single category.
These losses are not associated with any middle ear involvement and so tympanometry and clinical otologic examination should be normal. Of those who did improve, a large range was seen, with a few cases even showing a large spontaneous recovery. The possible advantage of IT administration is that it delivers a relatively high drug dose directly to the ear, thereby lowering the risk of systemic side-effects associated with oral steroids. However, since you cannot diagnose which type of hearing loss your child might be experiencing, prompt medical attention for any hearing loss is necessary.
As it is a medical emergency, a person who experiences SSHL should visit a doctor immediately. This will be used to determine whether the hearing loss is truly a sensorineural hearing loss or whether it is due to another cause such as wax build-up or otitis media. Adams has also shown that early introduction of steroids will effectively reverse this process. Stomach problems can also be prevented by antacids and other over-the-counter drugs used for ulcers and reflux. As can be seen in the case in Figure 1, both initial decreases and then improvements are expected for speech discrimination as well.
Speech intelligibility improved in both treated and untreated groups, but a significantly larger number of patients improved among those receiving steroids. Overall, however, the steroid-treated group showed larger improvements than the spontaneous improvements in the untreated group.
Research is underway to study whether IT steroids are as good or better than oral steroids, and whether the side effects are actually reduced.
Unfortunately, greater research is needed to understand the causes of and treatments for SSHL. The hearing evaluation will also be used to determine the degree of impairment and monitor any change during the course of treatment.An otolaryngologist may also recommend further tests to determine the underlying cause of the hearing loss.
As always, a full 50-item standard list (ie, CID W-22), presented via compact disk is the minimum for effective assessment of changes in speech intelligibility over time. The retrospective study showed that, while about 40% of each group failed to improve, in those cases where some recovery did occur, steroids seemed to assist the natural healing process resulting in larger hearing improvements. Until this research is complete, a tapering course of oral steroids remains the standard of care for SSNHL.
If you frequent rock concerts or work with power tools often, you might notice a stealthy, gradual decline in hearing. Your child has a better chance of regaining his hearing if his degree of hearing loss is mild. Sometimes the condition resolves itself or gets better with treatment, but sometimes it doesn’t.
The younger the patient, the greater likelihood of full recovery.If a sudden sensorineural hearing loss does not improve with medical treatment, the effects of the hearing loss can be managed with the use of hearing technology. Hearing technology and rehabilitation can be used to help alleviate some of these long-term issues.



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