Suddenly losing hearing in one ear can be terrifying. The rapid loss of hearing is called sudden deafness. We’ll discuss potential causes of sudden hearing loss on one side and how to treat it.
Sudden Hearing Loss
Also known as sudden sensorineural hearing loss (SSHL), sudden deafness refers to the rapid onset of hearing impairment. While the overwhelming majority of sensorineural hearing loss is gradual, sudden hearing loss appears instantly or over the course of a few days.
Sudden sensorineural hearing loss is rare, affecting nearly 4,000 people in the United States annually.
Nine out of 10 cases are unilateral hearing loss, meaning the condition occurs in only one ear, and the prognosis for these people is better compared to bilateral SSHL.
Sudden hearing loss is considered a medical emergency that requires prompt treatment, whether in one or both ears.
What Causes Sudden Hearing Loss?
Sudden deafness is a type of sensorineural hearing loss rooted in damage to the inner ear.
Sudden hearing loss can occur due to trauma, sudden exposure to loud noise, immune disease, snake bites, medications that harm to the inner ear, and circulatory conditions.
Here are some of the causes of unilateral SSHL.
Any trauma to the ear or head can cause SSHL, including:
- Exposure to extremely loud noise like gunshots and explosions.
- Temporal bone fractures, perilymphatic fistulas, and inner ear concussions
- Complications from head and neck surgery
- Extreme changes in air pressure from flying or diving
Autoimmune disorders are rare conditions where a person’s immune system attacks the body. These disorders can sometimes affect the ear.
- Behcet’s disease
- Cogan’s syndrome
- Temporal arteritis
- Wegener’s disease
- Lupus erythematosus
Infections can lead to sudden hearing loss in one ear.
- Lassa fever
Tumors and Neurological Causes
Issues in the brain, auditory nerve, and nervous system may cause sudden hearing loss, including:
- Benign tumors like vestibular schwannomas or acoustic neuromas
- Multiple sclerosis
A toxic reaction to medications or other harmful substances can cause sudden hearing loss. Examples include:
- Snake venom
- Cancer drugs
- Pain medications like NSAIDs and aspirin,
Conditions that affect blood vessels can compromise the blood flow in the ear, including:
- Sickle-cell anemia
- Subdural hematomas
Inner Ear Disorders and Other Causes
- Meniere’s disease
In addition to all these causes, some sudden hearing loss is idiopathic, meaning the reason is unknown.
Symptoms of Sudden Hearing Loss
Depending on the underlying cause, sudden hearing loss may be accompanied by many other symptoms, including:
- Ear pain
- Discharge from the ears
- Skin rashes
- Weight changes and loss of appetite
These symptoms seem very broad, but they can help a doctor identify what system or organs are affected. However, in some cases, rapidly appearing hearing loss may also be the only symptom, making the diagnosis more difficult.
Often, these symptoms may precede hearing loss, and documenting them is helpful to localize the cause. Some signs point to a more serious cause. Go to the emergency room or contact a doctor immediately if you notice:
- Loss of vision
- Painful headaches
Diagnosing Sudden Hearing Loss
Diagnosing sudden hearing loss can be challenging because there are many possible causes. You will likely need to see a series of medical professionals and undergo a battery of tests. On average, people with sudden hearing loss require different tests done.
Visiting an ENT or General Practitioner
If you experience sudden hearing loss, you should seek treatment immediately. Your first stop should be an ENT specialist or your primary care physician for an initial examination that will include:
- Reviewing the patient’s history, including medications and preexisting medical conditions
- Checking vital signs
- Inspecting the outer and middle ear for alternative causes of hearing loss like obstructions in the ear canal due to ear infection or ear wax buildup
- Blood tests for thyroid disorders, diabetes, and signs of diseases like Lyme disease
If the doctor cannot identify the cause of your hearing loss, they may refer you to an audiologist for a hearing test. Many ENT doctors have audiologists on staff who can conduct testing during the same visit.
Diagnosing most hearing loss requires a trip to the audiologist for a series of diagnostic tests, including:
- Pre-testing screening questionnaire
- Physical examination of the affected ear
- Hearing and balance tests, including pure tone audiometry
- Auditory brainstem response testing (ABR)
Though it’s not common, a doctor may order additional testing to determine the cause of hearing loss.
Some radiological exams are helpful in diagnosing hearing loss caused by tumors around the hearing nerve or ruling out middle ear conditions like otosclerosis.
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
- Electronystagmography (ENG)
The treatment of sudden hearing loss depends on the underlying cause.
In about half of the cases, the condition resolves on its own in one to two weeks. Nearly two-thirds of cases resolve without treatment.
It’s essential to bear in mind that once you treat the specific cause, you could still have permanent hearing loss. Your hearing may not return to its original levels.
Common treatments for sudden hearing loss include:
- Oral steroids and intratympanic (IT) corticosteroids
- Antiherpetic therapy like acyclovir
- Removing tumors
- Discontinuing harmful drugs
- Antibiotic, antiviral, diabetes, or thyroid medications
If the hearing loss doesn’t improve after considerable treatment, hearing aids can be considered. A hearing professional can set you up with a custom-fitted hearing aid for your ear.
The prognosis of the hearing loss depends on the cause, duration, treatment, and whether the condition affects the inner ear. Even without therapy, most folks will regain an average of 35 dB.
Prompt medical attention is essential—those who meet with a physician within a week of experiencing hearing loss fare better.
Younger people recover hearing faster while Those with vertigo and imbalance did worse. The presence of tinnitus was not a good sign for hearing recovery. Hearing recovery was better in those with a minor degree of hearing loss.
If you suddenly have difficulty hearing in one ear, there’s no need to panic. While you should treat the symptoms seriously and seek immediate medical attention, the condition will resolve on its own in most cases.
Early treatment is crucial to avoid permanent damage to your hearing ability, so you should contact a doctor immediately. A physician may prescribe antibiotics or antiviral medications for infectious causes, but the most common treatment is steroids.
1. Oh JH, Park K, Lee SJ, Shin YR, Choung YH. Bilateral versus unilateral sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2007;136(1):87-91. doi:10.1016/j.otohns.2006.05.015
2. Wilson W. R., Byl F. M., Laird N. (1980). The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Acta Oto-Laryngologica, 106, 772-776