Does this sound familiar?
“Suddenly couldn’t hear on my right ear any more. I feel pressure and ringing in my ear.”
“I suddenly lost hearing in my right ear. For no apparent reason.”
It is scary to wake up in the morning and not be able to hear out of one ear, but it happens every day around the world with a medical condition called sudden senorineural hearing loss, or sudden deafness. However, this is a misnomer, because the auditory nerve is almost never the cause. The problem is usually in the hair cells of the cochlea.
SSHL is the shortened abbreviation, and according to the NIDCD, approximately 4,000 new cases of SSHL occur in the USA each year. The prognosis is excellent as most people will experience a spontaneous recovery without medical intervention, often within the first 3 days. In some cases, it will be a slower recovery over a week or more. Unfortunately, for about 15 percent of those with SSHL, their hearing loss will get progressively worse over time.
Sudden hearing loss is a very problematical disorder because of the fact that it can affect each person differently, the causes are vast, and characteristics of SSHL make it hard to predict, when or if at all a person’s hearing will get better, go up or down or gradually deteriorate. There is no set course of treatment that will work on everyone. A doctor will need to base his diagnosis based on your medical history and his physical findings.
SSHL and can happen to anyone. People of all age groups can be affected by sudden hearing loss. However, it does seem to occur more in the median age group of 30-50 years of age, and is equally divided by both men and women. The pattern of onset of SSHL finding is consistent with most cases of sudden hearing loss occurring abruptly or roughly over a 3 day time span.
Hearing loss is the third most prevalent chronic condition in older Americans, after hypertension and arthritis1; between 20% and 45% of the population of the median age of sixty five is hearing impaired. Hearing loss of any kind can have significant effects on their physical and mental health. Sudden hearing loss does not cause pain, but the emotional impact can be far-reaching affecting home life, work, and the emotional well-being of the person suffering from SSHL. It is common for people with hearing loss to find communicating with others more difficult and tiring, leading to frustration and anger. This can lead to a downward spiral and feelings and threaten the emotional well–being of the individual.
1. Causes of sudden hearing loss
More than 100 possible causes of sudden hearing loss can be identified, and it is rare to determine a specific cause accurately. The figure shows that only 10 to 15 percent of SSHL patients know why they lost. The greatest number of ISSHL cases can be very frustrating for doctors as the cause is idiopathic or unknown.
Possible causes include the following:
COMMON REASONS:
- Ear Wax Impaction
- Chronic supurative otitis media Ear Infections
- Sinus Blockage
- Insects In Ears
- Chronic supurative otitis media Ear Infections
- Rubella Syndrome
- Congenital Atresia Of The External Auditory Canal
- Congenital Cytomegalovirus
- Congenital Perilymphatic Fistula
- Fetal Methyl Mercury Effects
- Congenital Atresia Of The External Auditory Canal
- Chronic supurative otitis media Ear Infections
- Sinus Blockage
- Insects In Ears
- Chronic supurative otitis media Ear Infections
CONGENITAL:
- Rubella Syndrome
- Congenital Atresia Of The External Auditory Canal
- Congenital Cytomegalovirus
- Congenital Perilymphatic Fistula
- Fetal Methyl Mercury Effects
- Congenital Atresia Of The External Auditory Canal
MEDICATIONS:
- Ototoxic Drugs (Drugs That Harm The Ear)
- Aminoglycoside Antibiotics
- Cancer Therapy Treatments
- Ethacrynic Acid - Oral
- First List Item
- Chloroquine
- Cancer Therapy Treatments
INFECTIOUS DISEASES:
- Meningitis
- Mumps
- Measles
- Ear Infection (Otitis Media)
- Scarlet Fever
- First List Item
BACTERIAL INFECTION:
A non-controlled studies reported that 17-33% of patients with sudden hearing loss remember a recent viral illness. Loss of hair cells and neuronal losses were observed. These models were similar to findings in documented cases of hearing loss after a patient had mumps, measles, and maternal rubella. Viral infection can sited as a cause of ISSHL, but has not been confirmed.
VIRAL INFECTIONS:
- Colds
- Adenovirus
- Cytomegalovirus (Cmv)
- Infectious Mononucleosis
- Influenza
- Parainfluenza
IMMUNOLOGIC DISEASES:
The evidence is building as more studies show that there can be a progressive sensorineural hearing loss observed with immune-mediated inner ear disease. The reasons are unclear, but immunologic activity within the cochlea is thought to be the cause. There are documented connections of hearing loss in Cogan syndrome, systemic lupus erythematosus, and other autoimmune rheumatologic disorders.
- Cogan’s Syndrome
- Lupus
- Fibromyalgia
- Autoimmune Inner Ear Disease "AIED" a syndrome of progressive hearing loss and/or dizziness which are caused by antibodies or immune cells which are attacking the inner ear.
TRAUMATIC:
The cochlea the auditory portion of the inner ear and is extremely sensitive to changes in blood supply. Reduction or blockages of the blood supply due to blood clots, stroke, high blood pressure, or trauma can cause sudden hearing loss. It has been sited that blockage of the blood flow to your inner ears can result in permanent hearing loss in under a minute.
- Traumatic Perforation Of The Eardrum
- Head Injuries
- Skull Fracture (Temporal Bone)
- Blood Clot
- Post–Coronary Artery Bypass Graft
DISEASE PROCESSES:
- Leukemia
- Circulatory Problems
- Diabetes
- Hypothyroidism
- Multiple Sclerosis.
- Ménière’s Disease
- Syphilis
ACOUSTIC TRAUMA:
- First List ItemLoud Explosive Noise
- Explosions
- Fireworks
- Gunfire
- Rock Concerts
- Mp3 Players
- Machinery
- Jets
- Occupational Work Noise
BAROTRAUMA:
Barotraumas is when pressure the air pressure in your middle ear and the air pressure in the environment are out of balance. The pressure during a trip in an airplane can causes changes in pressure that can result in sudden hearing loss.
- Scuba Diving
- Air Plane Passengers
- Sky Diving
- Blow To Ear
CANCER / TUMORS:
- Abnormal Tissue Growth
- Acoustic Neuroma
- Vestibular Schwannoma
- Temporal Bone Metastases
- Carcinomatous meningitis
TOXIC:
- Exposure To Pesticides
- Snake Bites
- Chemicals –home or occupational
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2. The emotional impact of sudden hearing loss
“I am profoundly deaf in my right ear with severe in the left and suffer from constant ringing in the ears. Phone conversations can be difficult due to my inability to be able to communicate effectively.”
temporary hearing loss sudden,
Reactions To Sudden Hearing Lose:
- Insecurity
- Loneliness
- Embarrassment
- Loneliness
- Stress
- Isolation
- Frustration
- Anxiety
- Depression
- Difficulty in social situations
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3. Tests your doctor may order
Inner Ear Work Ups Inlcude:
Audiometry: pure-tone and speech tests and immittance (tympanometry and acoustic reflex) tests, is mandatory.
- Auditory brainstem response testing and otoacoustic emissions.
- Vestibular tests
Laboratory Studies:
- Blood Tests
- (FTA-Abs)
- (ANA)Antinuclear antibodies, rheumatoid factor, and (ESR) erythrocyte sedimentation rate for autoimmune diseases
- (INR), activated partial thromboplastin time (aPTT), and clotting time for coagulopath
- CBC checking for infection
- (TSH) Thyroid
- Bloods Tests For Cholesterol and triglycerides for hyperlipidemia
- Imaging Studies
- MRI
- (FTA-Abs)
You now know that you are not alone. There could be a hundred reasons why you have experienced sudden hearing loss or SSHL, and perhaps you are one of the lucky individual that may be able to determine the contributing factors. However, with most cases of sudden hearing loss, the reason will be unclear. You may have a spontaneous recovery, or you may continue to having hearing difficulties. Continue on to page 2 for treatment options that are available.
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It has been established that hearing impairment comes to pass when the hair cells of the inner ear and the neural pathways to the auditory cortex are damaged, injured. In the ballpark of 23 % of the population over 65 years of age are showing signs of having minor to severe hearing impairment. This number will grow larger as younger individuals are losing their hearing due to listening to loud music, working in noisy environments, and not using hearing protection.
While treatments for abrupt hearing loss can consist of the use of vasodilator, antiviral drugs, steroids, dietary changes, and prescribed diuretics, it’s been noted that in in the ball park of a third to over half of the populace that fit the criteria for sudden hearing loss have spontaneous recovery of their hearing without being treated.
It should be noted for individuals with hearing loss look for treatments for their hearing loss that recovery commonly happens inside of 2 weeks of the unexpected hearing loss occurrence. This information can be used to explain the reasoning of many hearing specialists still prefer to use anti-inflammatory treatments as the first course of action. Steroids are usually prescribed to patient who is sudden unilateral hearing loss. The steroids are either taken orally or intravenously for a duration of 2 weeks, however, 30 % to 5o% of patients do not get any benefit to the treatment, and this leaves an open void that needs to be filled by new improved treatments for sudden hearing loss.
New more experimental treatments for temporary hearing loss can include giving intratympanic steroid injections into the eardrum, and low level laser therapy. This course of treatment can be particularly practical to individuals who don’t get results from high doses of steroids. It has been viewed that by having these shots in the eardrum, the patients have shown a propensity toward a higher recovery. There are other treatments being studied for temporary hearing loss, but their effectiveness and gain to the patients has still yet to be clinically established. New Treatments Being Tested
Hyperbaric oxygen:
it is being studied by researchers in Europe as a possible way to augment the inner ear oxygen levels to help and bring back ear cells, and hair. Its success has not been widely recognized, but one advantage is that it has no troublesome side effects. More studies will be needed to ascertain the effectiveness of such a treatment.
Low Level Laser:
Low Level Laser:
this treatment has been offered as a twofold treatment. It is believed to offer both worth in treating tinnitus (noise or ringing in the ear) and hearing loss as well. It was first studied in the early 1980s, and a new “Study of Low Level Laser Therapy and Word Recognition in Hearing-Impaired Individuals” is ongoing. Low-level laser therapy for hearing loss is thought to activate the mitochondria of the adipocyte cells, in return this increases the creation of ATP, which works to repair the damaged ear hairs and cells. A number of patients who have experienced hearing loss have sought treatment using low level lasers in the US and other countries, and have communicated having some improvement in their hearing loss. The laser at theat this time is advertised more for sufferers of tinnitus who are looking for other forms of treatment. Most tinnitus sufferers are delighted with the success the low level laser is providing as a sucessful treatment for their difficult tinnitus. The medical community and those sufferers of sudden hearing loss and sudden unilateral hearing loss, and other forms of hearing loss will continue to wait for better treatment options to become available. That is why it is so vital to protect your hearing while you still have it!
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