Sudden Hearing Loss : Causes, Diagnosis, Treatment, Prevention

“Not every deaf man is deaf from birth.” There are people who suffer from permanent deafness from birth, as well as there are some who get encountered with a kind of sudden hearing loss (SHL) that may persists on a temporary basis (Rare cases also be permanent). Permanent deafness is a condition in a person’s life where he is restricted from hearing completely forever. 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. 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. 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.

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. “Odds are not always decided from the birth. There are problems which come in to live at certain circumstances which are pretty different from the usual ones. 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. 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 are also some idiopathic conditions that create sudden hearing loss.

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. People who get exposed to the heavy noises at workplace or at home with leisure activities like loud music; where the noise reaches something above 85 decibels for a longer period of the exposure; are likely to suffer sudden hearing loss. 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. Studies involving sudden hearing loss have also found that 20% to 60% of the sudden hearing loss resulted from Vertigo. As it is, “Nothing is fair when exposed out of the limit.” Though the signs of this sudden hearing might leave early in some mild cases; there are conditions where the symptoms persist long and may be severe.

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. Such kinds of sudden hearing loss occur mainly with loud noise exposure for long time.

• Viral diseases
• Vascular diseases
• Trauma of external and internal ear
• Neurological conditions and
• Drugs and chemical poisoning

There are some rational approaches in the treatments available for sudden hearing loss which must be given a thought. The diagnosis procedures usually decide about the type of treatment to be undertaken by the patient. Let us discuss on the diagnosis and some of the treatment procedures for sudden hearing loss or sudden sensorineural hearing loss.

“There is always a test to know the condition for making any further remark.” The same thing happens in case of the sudden hearing loss. 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. 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 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. These audiograms are actually the graphical presentation of the audible threshold for the standardized frequencies that are measured by an audiometer. 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.

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.

1. 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. (Nageris and Popovtzer, 2003) are to be diagnosed for making a check on the cause of sudden hearing loss in case of any symptoms and to go for the respective treatment for the level of hearing loss occurred due to the same. MRI testing for brain can be sometimes effective here.
2. Audiometric Testing: There are some kind of audiometric testing for sudden hearing loss, which are done with the help of an audiometer. Pure tone and speech audiometry, tympanometry, otoacoustic emissions (OAE) etc are some of the known audiometric testing.
3. Additional Test: Some special tests for diagnosing the condition of sudden hearing loss in special cases: There are certain other cases or conditions in human, which can lead to a sudden hearing loss. Accordingly there are special tests for the special cases that lead to sudden 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.

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. Any treatment begins with the thorough consultation and mutual understanding between the doctor and the patient. Now coming to the treatments available for SHL, there are no such preferred treatments noted. However, there are some possible treatments available for such conditions which are based on rational approaches. 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.

1. 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. This reduction in blood viscocity can be done with the use of low molecular weight dextrans or anticoagulants like Heparin. This kind of treatment can be tried for treating sudden hearing loss.
2. Vasodilators For Treating Sudden Hearing Loss: Vasodilators are the agents which help in enhancing the blood flow to the cochlea. This helps in reversing hypoxia. Some of the most common agents used for improving the cochlear blood flow, includes Papaverine, Histamine, Procaine, Niacin, Nicotinic acid, Carbogen etc. Studies have found that carbogen when combined with drugs, works better than the therapeutic drugs for the treatment of sudden hearing loss.
3. 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. However, it is also found that oral steroid doses have a lot of side effects and the steroid injections are pretty costly.
4. Though there is no proper explanation on the mechanism of treatment; the Corticosteroids are known to be effective in treating the sudden hearing loss; and in fact these are the chief anti-inflammatory agents used for treating the sudden hearing loss, especially the Idiopathic sensorineural sudden hearing loss (ISSHL).
5. Anti-Viral Treatments: There are some known anti-viral agents which are proposed in treating sudden hearing loss. Acyclovir and amantadine are two such names, but with limited use in the treatment procedure. Two alternative names Famiclovir and Valacyclovir, have come in to the list of consideration for treatment for sudden hearing loss. However there are no such reports of their use till now in the treatment procedure. These anti-viral agents actually inhibit the Viral DNA polymerase and thus restrict the viral DNA from replicating.
6. Treatments via Triiodobenzoic Acid Derivatives: There are some agents which are thought to help in maintaining the endocochlear potential. 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.
7. 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. This is the hyperbaric oxygen therapy. 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.
8. Other Treatments: There are some other treatment methods and treating agents which can be tried out as proposed by certain researchers and in some studies; however due to lack of proper explanation on the same, it is not enough worthy considering such kinds of treatments for the sudden hearing loss under the major considerations. Treatments via diurectics and certain minerals and vitamins can be effective but there are no proper evidences or explanation on the same.

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. 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. 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., which can lead to sudden hearing loss.

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