For most people, hearing loss happens gradually over time. You probably don’t notice changes in your hearing from one day to the next.
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But sometimes, hearing loss can come on suddenly and without warning.
This is called sudden sensorineural hearing loss, or sudden hearing loss. It’s when someone loses hearing — usually just in one ear — over the course of three days or less. It can happen to anyone but is most common in adults in their 40s and 50s.
While it can be easy to brush off a sudden change in your hearing (maybe my ear is just clogged or it’s my allergies acting up), it’s actually very important to see a doctor right away if this happens.
“There are not many emergencies of the ear, but this is one thing that we would consider an emergency,” says ear surgeon Erika Woodson, MD.
There can be other causes of sudden changes to your hearing, but if it is SSNHL, it needs treatment — and the sooner, the better.
SSNHL vs. other ear issues
Sudden sensorineural hearing loss is different from the common temporary phenomenon called eustachian tube dysfunction. This is the cloudy hearing and full feeling in the ear that you might experience when traveling on an airplane. It’s also different from a feeling of blockage caused by allergies or a cold, though it can feel similar.
SSNHL happens because of damage to the inner ear, or because of problems with the nerve fibers that deliver information from the ear to the brain. Most of the time, there’s no clear rhyme or reason why it happens to someone. It can be either temporary or permanent.
So, if you experience a sudden change in your hearing, how do you know whether it’s SSNHL or one of these other things?
Any kind of noticeable hearing loss should prompt a visit to your primary care doctor or urgent care center for investigation, Dr. Woodson says.
The presence of dizziness or vertigo along with hearing loss can be clues of SSNHL, she says. Some people also report a strong ringing in their ear before their hearing fades.
“That’s because the brain does not know what to do with the changes of signal it’s getting from the ear, so it either misinterprets what bad signal it’s getting as noise, or it’s trying to fill in the gap — almost like a phantom sound,” she explains.
An ENT can help get to the bottom of the problem
If a primary care or urgent care provider doesn’t see any signs of blockage or infection in the ear that could be causing sudden hearing loss, the next step is quick referral to an ear, nose and throat specialist.
The ENT specialist will want to rule out anything else that could be causing the symptoms and give a hearing test.
“Many of these patients would not have a baseline hearing test for comparison, but in those circumstances, what we’re mostly looking for is asymmetry, or a difference between the two ears,” Dr. Woodson explains.
They may also order an MRI to rule out other problems, such as benign tumors that form on the hearing and balance nerves. These are called acoustic neuromas. “These are uncommon tumors, but this is the way they tend to pop up first, with sudden hearing loss,” Dr. Woodson says.
If SSNHL is determined to be the culprit for the hearing loss, the next step is steroid therapy to reduce inflammation in the inner ear. This typically starts with oral treatment (pills), but depending on the situation and the patient, injection of steroids into the ear drum could also be an option.
Does hearing come back?
Studies have found that half to two-thirds of people who experience SSNHL recover their hearing. Those who don’t may benefit from other treatments such as hearing aids or cochlear implants.
While there isn’t necessarily a way to predict who will and who will not get their full hearing back, Dr. Woodson notes that people with only mild hearing loss who seek treatment within a week tend to have higher rates of recovery.
In the same vein, it’s hard to know who is going to experience sudden hearing loss in the first place. But Dr. Woodson says recent research has uncovered associations between SSNHL and vascular risk factors such as high cholesterol, diabetes and hypertension.
“Anything that can affect the little blood vessels coursing through our body can make somebody more likely to have sudden sensorineural hearing loss,” she says.
So the best thing people can do to avoid it? “Take care of themselves and their chronic medical problems,” Dr. Woodson says. “All the things that are important for heart health are important for ear health as well.”