Medicines for Sudden hearing loss

What it is

Sudden sensorineural hearing loss is a rapid loss of hearing — usually in one ear — that develops over a short period, typically within three days (often over hours, or noticed on waking). "Sensorineural" means the problem is in the inner ear or the hearing nerve, rather than a blockage of the ear canal (such as earwax) or a middle-ear problem. It is important to recognise because it is regarded as a medical emergency: prompt treatment, ideally started as soon as possible (within days), offers the best chance of recovering the hearing, whereas delay reduces the chance of recovery. As well as the hearing loss itself (which can range from mild to complete, and may make sounds muffled or distorted), people often have a feeling of fullness in the ear, ringing (tinnitus), and sometimes dizziness. In most cases, no specific cause is found (it is often "idiopathic"), though it is thought to sometimes relate to viral infections, problems with the blood supply to the inner ear, or other causes; occasionally it points to an underlying condition that needs identifying. Because it can be mistaken for a blocked ear (from wax or a cold), and because early treatment matters, sudden hearing loss in one ear should be treated as urgent and assessed promptly. It is confirmed with a hearing test.

How it is treated

Sudden sensorineural hearing loss should be assessed urgently, as prompt treatment gives the best chance of recovering hearing. Because it can be confused with a blocked ear (from wax or a cold), a doctor first checks that the ear canal and middle ear are clear, and a hearing test confirms that the loss is sensorineural. Once confirmed, treatment is usually started as soon as possible: the main treatment is a course of steroids (corticosteroids), given by mouth and/or by injection directly into the ear (through the eardrum), which aim to reduce inflammation and give the best chance of hearing recovery — the sooner this is started, the better. The person is usually referred urgently to an ENT specialist. Investigations are carried out to look for any underlying cause (which may include further tests, and sometimes a scan, for example to exclude a rare cause such as an acoustic neuroma, particularly if the hearing loss is one-sided and persistent). Any underlying cause found is treated. The hearing is monitored, and support (including hearing aids) is provided for any hearing loss that remains. Outcomes vary — some people recover fully, some partially, and some have lasting hearing loss — with prompt treatment improving the odds. The reassuring message is that sudden sensorineural hearing loss is treated as an emergency because early treatment (usually steroids) gives the best chance of recovering hearing — so sudden hearing loss in one ear should be assessed without delay, not assumed to be just a blocked ear.