Sudden sensorineural hearing loss (SSNHL) is defined as a rapid loss of hearing of 30 decibels (dB) or more in one ear, affecting at least three sound frequencies, and happening within 72 hours or less. It usually affects one ear and is considered a medical emergency because early treatment can significantly improve recovery.
People with SSNHL often notice a sudden drop in hearing, sometimes when they wake up in the morning or while using the phone. The hearing loss can range from mild to complete. Many describe the ear as feeling “blocked” or “full,” which is often mistaken for earwax or a common ear blockage. Around 70–90% of patients experience ringing in the ear (tinnitus), and about 30–40% may feel dizziness or imbalance (vertigo), showing inner ear involvement. Usually, there is no pain, discharge, or visible issue when the ear is examined.
What causes it?
In many cases, the cause of SSNHL is unknown, called idiopathic SSNHL. However, possible reasons may include:
Viral infections such as herpes, mumps, or influenza
Problems in blood supply to the inner ear
Autoimmune ear disease (when the immune system attacks the ear)
Tumors like acoustic neuroma
Side effects of certain medications (ototoxic drugs)
Head or ear injury
Diagnosis:
The diagnosis is confirmed through a hearing test (audiometry), which helps differentiate between nerve-related (sensorineural) and other types of hearing loss. Simple tests using a tuning fork (Rinne and Weber tests) can give initial clues — for example, sound heard better in the opposite ear suggests SSNHL.
An MRI scan of the brain and ear canals is often done to rule out tumors or other inner ear problems. Blood tests may be suggested in some cases to check for infections or immune-related causes.
Treatment:
Quick treatment — ideally within the first two weeks — gives the best chance of recovery. The main treatment is steroids, which reduce swelling and inflammation in the inner ear.
Steroid Injections in the Ear- Used when oral steroids can’t be given (such as in diabetes or high blood pressure) or when oral treatment doesn’t help.
Other Supporting Treatments – Antiviral medicines may be given if a viral cause is suspected, though evidence is limited. Blood-thinning medicines are sometimes used to improve blood flow to the inner ear. Hyperbaric Oxygen Therapy (HBOT) may also help if started early, by improving oxygen supply to the inner ear tissues.
Recovery and Prognosis
Some people recover naturally — around 30–60% regain hearing within two weeks. Recovery is usually better when:
· Hearing loss is mild or moderate
· Only low-pitched sounds are affected
· There is no dizziness
· Treatment starts early
On the other hand, complete or deep hearing loss, delayed treatment, and severe vertigo may reduce the chances of full recovery. In short, SSNHL needs quick medical attention. Recognizing the symptoms early and starting steroid treatment on time can make a big difference in hearing recovery.
