What Happens if You Lose Your Hearing Overnight? Sudden Sensorineural Hearing Loss

Understanding Sudden Sensorineural Hearing Loss (SSHL)

Sudden Sensorineural Hearing Loss (SSHL), often referred to as sudden deafness, is a rapid, unexplained loss of hearing. It typically affects only one ear and can occur all at once or over a few days. The condition arises from issues within the sensory organs of the inner ear​​. While the cause of SSHL is largely unknown, about 10% of cases have identifiable causes such as infections, head trauma, autoimmune diseases, exposure to certain drugs, blood circulation problems, or neurological disorders​​.

Symptoms and Prevalence

The onset of SSHL is often startling, with many individuals discovering their hearing loss upon waking up. Symptoms include ear fullness, dizziness, and tinnitus (ringing in the ears)​​. SSHL can occur at any age but is most prevalent in adults in their late 40s and early 50s. It's estimated to affect between one and six people per 5,000 annually, although this number might be higher due to undiagnosed cases​​.

Diagnosis and Treatment

Immediate medical attention is crucial for SSHL. Pure tone audiometry is a common diagnostic tool, which measures hearing ability across different sound frequencies. A significant SSHL indicator is a loss of at least 30 decibels in three connected frequencies within 72 hours​​.

The primary treatment for SSHL is corticosteroids, which reduce inflammation and swelling. These can be administered orally or via intratympanic injections directly into the middle ear. Early treatment, ideally within two to four weeks of symptom onset, is vital for the best possible recovery​​.

When Treatment Doesn't Fully Restore Hearing

In cases where hearing loss is severe or does not respond to treatment, hearing aids or cochlear implants may be recommended. These devices amplify sound or stimulate auditory connections in the ear, respectively​​.

"every second that goes by without proper diagnosis or treatment could be the difference between recovering your hearing or losing it forever." - Dr. Rachael Cook

The Importance of Expert Guidance

Sudden hearing loss, as experienced by individuals like Paul Simon, underscores the need for awareness and timely intervention. If you or someone you know experiences rapid hearing loss, it is essential to seek immediate evaluation by an audiologist or an ENT physician.

Sudden hearing loss is a medical emergency that requires immediate attention. Understanding the symptoms, seeking prompt diagnosis and treatment, and considering all available hearing solutions are crucial steps in managing this condition effectively. Remember, timely intervention can make a significant difference in the outcome.

Video transcript

Video transcript

Imagine waking up after a normal night of sleep to find that your left ear doesn't seem to hear a thing. After wiggling your ear around and trying to pop your jaw, you put your headphones in only to find that the clean and clear sound quality you hear in the right ear sounds distant, muffled, or distorted in the left ear. You might assume that this overnight hearing loss is due to earwax buildup, maybe a developing ear infection, your allergies acting up, or even just a change in pressure from the weather, and it certainly could be. However, in some cases such as that of American singer-songwriter Paul Simon, it was much worse than that. During the writing and recording of his newly released album, Seven Psalms, Paul Simon of Simon and Garfunkel experienced a condition called sudden sensorineural hearing loss in his left ear. Unfortunately, his sudden hearing loss was permanent and ultimately led to him leaving the music industry.

The scary thing is this could happen to anyone. During my time working as an audiologist at an ENT office, I saw sudden sensorineural hearing loss all of the time. That's why in today's video, I'll tell you what sudden sensorineural hearing loss is, how to know if it's happening to you, and what can be done to treat it. But before we do that, if you could give this video a thumbs up to bring videos like these to a wider audience, we would really appreciate it. And while you're at it, if you take a moment to hit the subscribe button with notification bell, that'll make sure that you never miss any one of our newly released videos. Sudden sensorineural hearing loss is the rapid development of significant hearing loss generally in one ear, but in rare cases in both ears. This hearing loss develops nearly instantaneously, but can continue to develop over the course of three days and is often accompanied by pressure, fullness, and ringing or buzzing in the ears called tinnitus.

The rapid development of symptoms in this condition is what really sets it apart from things like allergies or an ear infection which develop much more gradually. Sudden sensorineural hearing loss can develop at any age, and researchers put the prevalence somewhere between five and 20 individuals per 100,000 people. Unlike a conductive hearing loss that can be caused by earwax or ear infections, sensorineural hearing loss is caused by damage to the delicate inner and outer hair cells in your hearing organ, the cochlea. Researchers aren't exactly sure why this happens as it seems to happen randomly between men and women at any age with very different health histories. I can attest to this as nearly every patient that I saw for the monitoring and treatment of their sudden loss fit into completely different patient profiles with hardly any common ground between them. But researchers theorize that it's likely due to one or more of the following factors: viral infections, circulatory disorders, autoimmune diseases,

ototoxic medications that are dangerous to the inner ear, or head trauma. Researchers are even investigating the rise in sudden sensorineural hearing loss cases during and after having COVID-19 or the COVID-19 vaccination, although this suspected connection is still in the very early stages of analysis. Regardless of the cause, if you or your family members experience these symptoms, do not write them off as just having some allergies or maybe a little cold. In this situation, the worst thing you can do is wait for it to resolve on its own. This condition requires immediate medical attention from an ENT physician and an audiologist, including a comprehensive hearing evaluation to determine the type and severity of your hearing loss. Surprisingly, many medical professionals outside of hearing healthcare are not familiar with this condition, often prescribing decongestants or antibiotics for an ear infection that doesn't exist.

All too often I would see patients weeks or months after the onset of their symptoms, putting them well outside the effective treatment window. According to the updated 2019 American Academy of Otolaryngology clinical practice guidelines, those with suspected sudden sensorineural hearing loss should obtain a hearing evaluation and corticosteroid treatment within two weeks of symptom onset for best outcomes. Steroid treatment helps to reduce inflammation and suppress immune responses that may have caused the hearing loss in the first place. High dose steroids such as prednisone are either given orally in pill form or are injected directly into the middle ear space through the eardrum in what's called trans-tympanic injections. Treatment for this condition generally occurs over several weeks, often starting with a hearing test to confirm the loss, followed by a round of oral steroids and an updated hearing test about a week later. Many times, if there has been minimal or no change in hearing, trans-tympanic injections will be completed between one and three times with hearing tests between each treatment to monitor improvement.

However, clinical protocols vary from practice to practice depending on your age, level of hearing loss, and symptom onset. Treatment may involve several combinations of oral or trans-tympanic steroid injections over days or weeks with updated hearing evaluations in between to monitor progression or improvement. Unfortunately, even with proper treatment administered quickly, there is no way to guarantee recovery of your hearing. Because this condition presents so differently from person to person, it's almost impossible to predict who will see recovery in their hearing and to what degree. Researchers theorize that the effectiveness of this treatment is dependent on the severity of the initial hearing loss, the age at which this occurred, and the time between symptom onset and receiving treatment. Without medical intervention, studies suggest that somewhere between 32 to 65% of people see some level of recovery

without treatment. These results are not very comforting as that range is pretty broad, and some recovery may mean only minor improvements when compared to your hearing before the sudden loss. As with any medical treatment, the main goal is that recovery is quick and complete, but what happens if the treatment is not effective or only recovers some of the hearing that was lost? In many cases, the best and only treatment option for sensorineural hearing loss is hearing aids. Hearing aid candidacy is dependent on the level of damage within the cochlea your hearing organ. In some instances, the missing speech sounds from the sudden loss can be returned back up to the brain through the use of properly programmed hearing aids. For others, the level of damage in the cochlea is too severe and amplifying the missing speech sounds may make things louder, but does not improve clarity or understanding.

In these cases, alternative hearing treatment such as CROS and BiCROS systems and even cochlear implants may be more effective. For more information about these treatment options, make sure you check out our Dr. Cliff Show podcast episode with Dr. Scot Frink on single-sided deafness or Dr. Cliff's video on cochlear implants. As for Paul Simon, we don't know how quickly he sought treatment or what course of action was recommended, but the near total loss of hearing in his left ear has forced him to call it quits on performing. But it is my hope that increasing awareness of this condition and the need for prompt medical attention gives people their best chance at seeing recovery. If you or someone you love develops a rapid significant hearing loss in one or both ears, you should see an audiologist immediately for a comprehensive hearing evaluation and to get pointed in the right direction for treatment because every second that goes by without proper diagnosis or treatment could be the difference between recovering your hearing or losing it forever.

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