Sudden Sensorineural Hearing Loss (Sudden Deafness)

Sudden sensorineural hearing loss is a rapid loss of hearing in one ear, developing at once or over up to 3 days, caused by a problem in the inner ear or hearing nerve and not by wax or fluid. People typically notice it on waking or when they use the phone on that ear.

It is a medical urgency. Treatment with steroids works best when started within days, ideally within 2 weeks. About a third to two thirds of people recover some or all hearing, with or without treatment, but recovery cannot be predicted for an individual.

Symptoms

• Sudden muffled or absent hearing in one ear
• A loud pop just before the hearing drops
• Ringing or roaring in the affected ear
• A blocked or full feeling in the ear
• Dizziness or spinning, which suggests a more severe injury
• Sounds seeming distorted or unpleasantly loud

Causes and risk factors

In about 9 out of 10 cases no cause is found. Suspected mechanisms are a viral infection of the inner ear, a disturbance of its tiny blood supply and autoimmune inflammation. Identifiable causes include a vestibular schwannoma, Meniere's disease, stroke in the brainstem circulation, head injury, sudden pressure change, medicines that damage the ear, Lyme disease, syphilis and autoimmune disease. Loss in both ears at once is rare and points to a systemic cause.

How it is diagnosed

• Ear examination and tuning fork tests: Rule out wax, fluid and eardrum problems, which cause conductive and not nerve-type loss.
• Pure tone audiogram: Confirms the diagnosis: a drop of at least 30 decibels across three neighbouring frequencies. It should be done within days.
• MRI of the inner ear canals with contrast: Arranged in the following weeks for everyone, to exclude a schwannoma or other lesion.
• Blood tests: Only when the history suggests infection, autoimmune disease or a clotting problem.
• Repeat audiograms: During treatment and at about 6 months to document recovery.

Treatment options

• Oral corticosteroids: Prednisolone at about 1 mg per kg, up to 60 mg daily, for 7 to 14 days and then tapered. Start as early as possible.
• Steroid injections through the eardrum: Dexamethasone into the middle ear, as first treatment for people who cannot take steroid tablets, such as some people with diabetes, or as rescue when tablets have not worked after 1 to 2 weeks.
• Hyperbaric oxygen: An optional addition to steroids within the first 2 weeks, or as rescue within about a month. The evidence is moderate.
• What does not help: Antivirals, blood thinners and vasodilators have not shown benefit and are not recommended routinely.
• Rehabilitation: Hearing aids, tinnitus management and, for profound permanent loss, assessment for a cochlear implant.

When it is urgent

Sudden hearing loss is itself the warning sign. See an ENT doctor or emergency department where you are within 24 to 48 hours. If it comes with facial drooping, double vision, slurred speech, weakness, numbness or a severe headache, call emergency services, as it may be a stroke.

Travelling to Türkiye for treatment

Do not travel for the initial treatment. Every day of delay lowers the chance of recovery, and flying with a freshly injured ear is unwise. Start steroids locally. Travel can make sense later: for an MRI and expert review if these were not done, for a hearing aid or tinnitus programme, or for cochlear implant assessment if hearing has not returned after several months.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions