Understanding Sudden Hearing Loss (SSNHL)

What You Need to Know about SSNHL

What is Sudden Sensorineural Hearing Loss (SSNHL)?
Sudden Sensorineural Hearing Loss (SSNHL) refers to a rapid decline in hearing, often occurring in one ear over a span of up to 72 hours. This condition affects the inner ear or the auditory nerve, and can result in anything from mild to complete hearing loss. Most commonly, individuals experience it suddenly, often waking up to find their hearing in one ear (or both) significantly diminished.
In addition to the loss of hearing, other symptoms may also accompany SSNHL, such as
• Sound distortion: People may hear sounds as unclear or garbled in the affected ear.
• Tinnitus: A ringing, buzzing, or hissing sensation in the ear or head.
• Dizziness or imbalance: A sensation of vertigo or unsteadiness.
• A sensation of fullness or blockage: Often described as pressure in the ear.
• Nausea and vomiting: Sometimes caused by the accompanying dizziness.
• Anxiety: The sudden onset of symptoms can lead to heightened stress or concern.

Though the incidence of SSNHL is relatively rare, affecting 5-20 people per 100,000, it is most commonly seen in individuals between the ages of 30 and 60. It affects both men and women equally.
The underlying cause of SSNHL is usually a loss of sensitivity in the cochlea (the hearing organ), which typically results in permanent damage. However, the good news is that in some cases, especially with prompt treatment, there is a possibility for partial or even full recovery of hearing.

What Causes Sudden Hearing Loss?
Sudden Sensorineural Hearing Loss can arise from various underlying conditions, though in many cases, no specific cause is identified. Approximately 10% of SSNHL cases have an identifiable cause. Common causes include
• Infections: Viral or bacterial infections affecting the inner ear can lead to sudden hearing loss.
• Head Trauma: Injury to the head or ear can disrupt hearing structures, resulting in sudden hearing loss.
• Autoimmune Diseases: Conditions where the immune system attacks the inner ear can cause SSNHL in one or both ears.
• Medications: Certain drugs, especially those used in chemotherapy or to treat severe infections, can damage the ear and cause sudden hearing loss.
• Blood Circulation Problems: Poor blood flow to the ear, often due to underlying health issues like high blood pressure or diabetes, can lead to hearing loss.
• Neurological Disorders: Diseases like multiple sclerosis can impact the auditory nerve and cause sudden hearing loss.
• Inner Ear Disorders: Conditions like Ménière’s disease can affect the inner ear and lead to sudden hearing loss.
• Tumours: Rare tumours on the auditory nerve (acoustic neuromas) can cause hearing loss in one ear.
Determining whether hearing loss affects one ear or both can help narrow down potential causes.

sudden hearing loss

Treatment Options for Sudden Hearing Loss
When the cause of sudden sensorineural hearing loss is unclear, steroids are often the first line of treatment. These medications are commonly prescribed because they have been proven to help improve hearing recovery in many cases. Steroids work by reducing inflammation and swelling within the cochlea, the part of the ear responsible for hearing. By controlling this inflammation, steroids can help restore normal function and promote healing of the auditory system.
This treatment is most effective when administered early, ideally within a few days of the onset of hearing loss. Hence, Audiologists urge a prompt visit to the Emergency ENT once sudden sensorineural hearing loss is discovered for immediate steroid treatment.

Long-Term Outcomes
For some individuals with sudden sensorineural hearing loss, hearing may not fully recover, even with treatment. In these cases, it becomes essential to protect any remaining hearing in both ears. To prevent further deterioration, it’s important to avoid loud environments and use hearing protection when exposed to noise.
If hearing doesn’t improve on its own or through medical intervention, a hearing aid may be recommended to help manage the loss and improve quality of life.
Additionally, tinnitus, a constant ringing or buzzing in the ear, may persist, regardless of hearing recovery. Managing tinnitus is possible through techniques such as relaxation exercises, sound therapy, and cognitive distractions, which can help reduce its intensity and make it less intrusive.