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Is Sudden Hearing Loss an Emergency?

When someone suddenly loses his or her hearing, it’s hard to know what to do or when to get help. Ear specialist Steven Rauch, MD offers insights about the different types of sudden hearing loss and when to seek treatment.

If you’ve experienced a time when hearing in one ear seems to be muffled or blocked abruptly, you were likely undergoing a form of hearing loss. There are two conditions that can cause a sudden loss of hearing like this: (1) conductive hearing loss and (2) sensorineural hearing loss.

Sudden conductive hearing loss occurs when there is damage to the outer or middle ear that prevents sound from travelling to the inner ear. A common reason this occurs is due to earwax buildup.

Sudden sensorineural hearing loss (SNHL) is the loss of nerve sensitivity. This is much more serious because there is only a small window of time to be treated before permanent damage occurs. It is much less common than sudden conductive hearing loss.

“Sudden sensorineural hearing loss seems to strike about one person in 5,000 every year,” said Dr. Steven Rauch, an ear specialist at Massachusetts Eye and Ear. “Here in metro Boston, it amounts to approximately three to five hundred cases a year.”

Because it can be difficult for anyone to tell the difference between these two types of hearing loss, Focus sat down with Dr. Rauch to review some commonly asked questions, and to conduct a quick test to determine whether to seek help immediately.

What causes sudden sensorineural hearing loss?

According to Dr. Rauch, it is not clear exactly what causes sudden sensorineural hearing loss. Viruses, blocked circulation, inflammation or an immune response could spark the loss of hearing, but there are no tests that can determine which is the actual culprit in a given patient.

What are the symptoms of sudden sensorineural hearing loss?

The primary symptom of sudden sensorineural hearing loss is a feeling of pressure or fullness in one ear. However, pressure due to earwax or water in the ear feels quite similar. Tinnitus, a ringing, hissing, buzzing, whooshing or roaring sound in the affected ear, usually accompanies sudden sensorineural hearing loss.

How serious is sudden sensorineural hearing loss?

“Sudden sensorineural hearing loss is a real ear emergency,” said Dr. Rauch. This is because there is a short window of time, maybe two weeks, when patients can be treated with some hope of regaining their hearing. With every day that passes, the chance of hearing recovery goes down.”

“The good news is that sudden sensorineural hearing loss is quite treatable,” he said. “But because the symptoms are not very scary, many patients just ignore them until it’s too late.”

Is there a way to know when hearing loss is an emergency?

There is a simple test that can be done at home—or wherever you are—to help determine whether sudden hearing loss is sensorineural or conductive, Dr. Rauch explained. It’s called “the humming test.”

If you have normal hearing in both ears and you hum, you hear the sound equally on both sides.

If one ear is blocked from congestion, water, or earwax (conductive hearing loss), the hum will be heard louder in the blocked ear. This is not an emergency, but may warrant follow up care with an ear, nose and throat doctor.

If you have nerve damage due to sudden sensorineural hearing loss, the humming  shifts away from the blocked ear and sounds louder in the good ear. This is an emergency.

“For anyone experiencing a loss of hearing, I would recommend doing a quick humming test to see if you should see a doctor right away,” said Dr. Rauch. “No matter the results, I would still monitor your blocked ear, as treatment may also be needed for conductive hearing loss.”

For more information and a demonstration of the humming test, watch the video above.

About Our Expert

Dr. Steven Rauch is an otolaryngologist in the Otology and Neurotology Division and Chief of the Vestibular Division at Mass. Eye and Ear. He specializes in the diagnosis and medical management of hearing and balance disorders. He sees patients at the Mass. Eye and Ear, Main Campus in Boston.

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