Hearing Loss

A reader writes: “I am a 62 year old male. I was recently diagnosed with a condition I had never heard before – sudden idiopathic sensorineural hearing loss – in my left ear involving the facial nerve that goes through the middle ear and to the brain.

It started with a ringing in the ear and then I went deaf and the right ear is super sensitive to sound. There is roaring and buzzing in the left ear. Would you be able to provide me with some information on this subject?”

I don’t have much knowledge about this condition. So, I asked our local expert, Dr. Neil Harris, a specialist in ear, nose and throat surgery to enlighten me with some details. Following is the summary of the information he sent me.

Sudden idiopathic sensorineural hearing loss is a condition which may surprise you as the name says – suddenly – like waking up one morning with a hearing loss. Or one may notice hearing loss over a few days

Fortunately, the vast majority of cases of sudden hearing loss affect only one ear, and the prognosis for some recovery of hearing is good.

There are mainly four reasons for sudden hearing loss. It may be due to viral infection in the inner ear, or loss of blood supply to that area, or rupture of cochlear membrane in the inner ear, or due to problems in the immune system.

Many cases, however, fit into the idiopathic category where the cause is not known. That is very frustrating situation when it comes to management.

In the U.S., it is estimated that five to 20 cases are reported per 100,000 persons. Many cases likely go unreported, and the incidence may be higher. A sudden hearing loss may resolve before the patient can be evaluated medically, making it unlikely for that individual to seek help.

Distribution of the condition is equal amongst males and females. Left ear is affected as frequently as the right. Sudden hearing loss in both ears occurs in approximately one to two percent of cases.

All age groups are affected by sudden hearing loss, but fewer cases are reported in children and the elderly. Young adults have incidence rates similar to those of middle-aged adults. The median age at presentation ranges from 40-54 years. The occurrence of sudden hearing loss across all age groups is an indication of the multifactorial nature of this clinical problem.

Sudden sensorineural hearing loss has been considered an emergency situation. Patient evaluation should proceed promptly and expeditiously. Early presentation to a physician and early institution of treatment improves the prognosis for hearing recovery. The immediate goal is to discover a treatable or defined cause of the sudden hearing loss.

There is no preferred treatment regimen for the condition. One textbook says that treatment can be based upon a rational approach – depending on the history, physical examination, and laboratory results. Should no definitive or treatable cause be found, the treatment regimen should be dictated by the most likely factors involved.

It is reported that 47 to 63 percent of patients recover their hearing spontaneously. These figures vary according to different studies utilizing different criteria for degrees of recovery. The true spontaneous recovery rate is unknown.

Unfortunately, existing studies have not provided answers to questions regarding the best method of treatment, prognostic factors in recovery, and the exact cause of sudden hearing loss. These are questions that require a lot of research.

In the meantime it is important that if you experience sudden hearing loss then report the situation immediately to your doctor. Let him decide how to manage the problem.

I hope this helps.

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