by Neil Bauman, Ph.D.
© December, 2011
A person asked, “I woke up this morning completely deaf in one ear. I went to my primary care physician and he gave me some drops for my ear and told me to come back in two weeks if my hearing doesn’t come back. This doesn’t sound like he is treating my hearing loss as a medical emergency. What should I do?”
A lot of people ask the same questions: “What kind of a doctor should I go to when I experience sudden hearing loss?” and, “What is the most effective treatment?”
If you make the wrong choice and don’t get effective treatment immediately when you should, you may condemn yourself to a life of permanent hearing loss. Thus you need to take action to get the treatment you need, when you need it.
“Cry Wolf” or Die—Take Your Pick
Far too many people relate to me how they went to their family doctors and because their doctors did not recognize the emergency nature of their hearing losses, their doctors did not give them the immediate, effective treatment they really needed. Instead, their doctors often took a “wait and see” attitude. As a result, these patients ended up with permanent hearing loss. Don’t let this happen to you.
Sudden hearing loss can result from many different conditions. Some are medical emergencies and others are not—just like having a heart attack is a medical emergency and heartburn is not. The trick sometimes is telling which is which since heartburn can be one of the symptoms of a heart attack.
You may feel foolish calling an ambulance and being rushed to the hospital only to discover it was heartburn and not a heart attack. However, doctors and paramedics would rather you call them first—and find out later it wasn’t a medical emergency—instead of waiting to be sure, and die in the process.
The same holds true with your ears. Sudden hearing loss could be caused by something as simple as putting your hearing aid on and thereby pushing some wax further down your ear canal so it blocks sounds from reaching your eardrum. Voila! Instant deafness. This is nota medical emergency.
In contrast, you may wake up one morning with no hearing in one ear. Chances are this is a medical emergency and you should seek effective treatment now!
In a recent email to me, one lady wrote: “Doctors do not know how to treat sudden hearing loss. I wrote my primary care physician a letter about this and sent him your article with it entitled: Sudden Hearing Loss Is A Medical Emergency. When I went to see him, he was afraid to call it an emergency and get me an appointment with an ear specialist, as someone might think he was ‘crying wolf’ and thus wouldn’t believe him in the future if it was not a ‘real’ emergency.”
This is a valid and very real concern of doctors—especially primary care physicians who are not specifically trained in the specifics of ear problems.
What’s the answer? To my way of thinking, if doctors cannot find anything obvious causing the sudden hearing loss such as wax blocking the ear canal, they should treat it as a medical emergency. It’s that simple!
This is not “crying wolf.” This is being responsible and saying, “I’ve looked and can’t see any obvious reason for this sudden hearing loss, so I am sending my patient to you for your expert opinion. It may be nothing, or it may be serious—but I just can’t tell which and I don’t want to risk my patient’s hearing by wasting time.”
Since ear problems could be minor or very serious, both you and your doctors would be wise to err on the side of “medical emergency” until this is ruled out. The cavalier “wait and see” attitude of many doctors lets the precious minutes in your “golden hour” tick away without your ears receiving any effective treatment. When finally the serious nature of your hearing loss is recognized, often many days later, it is then far too late for treatment to do much good.
Which Doctor Should I Go To?
“Harold” wrote: “On July 23rd at noon, I was sitting in my office. I realized that I had suddenly lost the hearing in my right ear as I could not hear anything over the phone. That ear now feels blocked.”
Quickly! Which doctor should Harold go to? Do you know?
When it comes to diagnosing and treating ear problems, doctors basically have three levels of “ear expertise.” They are from least to most—primary care physicians (PCP), ear, nose & throat doctors (ENTs) and otologists/neurotologists. Each has their own niche.
1. Medical Doctors/Primary Care Physicians (MD/PCP)
Often your first contact with the medical community is with a standard Medical Doctor (MD), often called a Primary Care Physician (PCP), General Practitioner (GP) or Family Doctor. These doctors have no specialized training in treating ear problems. However, you often need to go to one of these doctors in order to get a referral to an ear specialist such as an ENT or otologist.
Family doctors normally treat ear conditions of the outer ear and ear canal such as removing ear wax or treating infections in the ear canal. For problems in the middle and inner ear, they should immediately refer you to the appropriate ear specialist.
2. Ears, Nose & Throat Doctors (ENT)
The middle level of “ear expertise” is the Ear, Nose & Throat doctor, commonly referred to as an ENT. The fancy term for these doctors is otolaryngologist (OH-toe-lar-ing-JOL-uh-jist) or sometimes by the tongue-twisting name of otorhinolaryngologist (OH-toe-RYE-noe-lar-ing-JOL-uh-jist). (When you break this name down, it is easier to understand and pronounce. Oto—ear, rhino—nose and larynx—throat). Sometimes these doctors are called EENTs (eyes, ears, nose and throat doctors).
ENTs are medical doctors that have taken further training and specialized in problems of the ears, nose and throat.
Despite the name, ENTs do not spend a lot of their time working with ears. One otologist told me that he estimated the average ENT only spent about 5% of his time with ears. Thus you cannot expect them to be experts on many kinds of ear problems.
ENTs generally specialize in problems of the middle ear—typically middle ear infections and medical problems of the middle ear. This may include surgical procedures for things like otosclerosis, or removing middle ear tumors such as cholesteatomas. They may also perform CI surgery.
3. Otologists (Neurotologists)
At the top of the pile is the otologist (oh-TOL-uh-jist) and neurotologist (NEU-roe-oh-TOL-uh-jist). Otologists and neurotologists are medical doctors who have trained as ENTs and then completed additional studies is the sub-specialty of otology (or neurotology). These are the real ear experts and are the doctors that know the most about inner ear problems.
If you experience sudden hearing loss and there is no obvious reason, these are the doctors that most likely will be able to help you. In fact, otologists/neurotologists are the only doctors (as a whole) that seem to recognize the true emergency nature of sudden hearing loss. Unfortunately, there are not very many otologists/neurotologists in the country.
Finding an Otologist (Neurotologist)
Since otologists are few and far between, finding an otologist or neurotologist near you may be difficult, especially if time is an important factor. If you live in the United States or Canada, probably the quickest and easiest way to find an otologist or neurotologist is to go to the website of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS). Here’s how to do it.
1. Go to http://www.entnet.org. In the center of the page is a box “Find an ENT By“.
In this box you have several options. Don’t make your search too stringent or you may not have many “hits.”
2. Leave doctor’s “Name” blank.
3. You can put in a distance from you within which you are willing to travel. I suggest 25 or 50 miles. Then put in your zip code. If you don’t get any/many results, try again, but this time leave the distance and zip code blank, and instead choose your “State/Province” (or a nearby state if you live near the border of two states).
4. Under “Specialty” select “Neurotology” then click “Go.” See how many entries come up. If there are too many, you may want to narrow your search. If too few, make your search even wider.
5. Do the same search again but this time select the specialty “Otology.”
Note: a good number of doctors are listed under both neurotology andotology so there aren’t as many choices as you might first think.
6. To learn more about any given doctor, in the resulting list click on the doctor’s name. This will bring up a new screen giving the address and phone number of the doctor, his specialties and his education/training record.
7. Finally, contact the doctor that interests you the most or is at a convenient location to you.
Note: This website only lists doctors that are members of the AAO-HNS. No doubt there are other otologists and other ear specialists that are not members. Therefore, they are not listed here. However, this website gives you a good place to start your search for an otologist or neurotologist.
Otologists are a rare breed. In case you are interested, there are only 9 neurotologists, and 15 otologists listed for the whole of Canada. In the USA, the figures are 242 and 403 respectively.
If you leave “-Select One-” as the specialty, you will get a listing of ENTs. Remember, otologists are, at the same time, ENTs. If you check their personal listings, you will find that some of them list otology as one of their specialties. There are only 37 ENTs listed for Canada, and 2,610 for the USA.
Sudden hearing loss can be serious. If there is any doubt in your mind about any treatment (or lack thereof) you have received from PCPs and ENTs, don’t delay. Contact an otologist/neurotologist as soon as possible.
HELP :'(
so scared basically I’ve been ill for 5 days so far
started off with a very soar throat and cough
then 3 days in bang massive ear infection in BOTH ears was so painful
and since then I’m deaf
both ears I can’t hear when people talkin unless there close
doctors said after 10-14 days I will be able to hear do I need to worry if I will be permanent deaf
so scared as only 20 and half deaf is upsetting me alredy
Hi Rachel:
It’s hard to tell from your description, but I think that your doctor is right–you have middle ear infections that have clogged up your middle ears so the tiny bones can’t vibrate freely and thus you have a conductive hearing loss. As long as it is a conductive loss, you don’t have to worry. When the infection dies and the gunk drains out through your Eustachian tubes, then your hearing will return. It can take up to 3 months for this to happen in some people. Much quicker in others.
Just be careful with the antibiotics you take as some of them can cause permanent hearing loss.
There is the odd chance that the cold virus gets into your inner ears. If that happens, it can cause permanent hearing loss. Then you’d have a sensorineural hearing loss. A complete audiological evaluation can tell you exactly what you have. If you want to, go to an audiologist for this.
I know it is scary to lose half your hearing overnight so to speak. You think you can’t hear much at all. Be thankful you still hear as much as you do. I’ve NEVER heard as well as you do now. Furthermore, my hearing is much worse than yours now that I am older. But I’m happy and not scared because I know that I can successfully live with my hearing loss.
Cordially,
Neil
I have sensorineural hearing loss. I am looking for a specialist to further understand and get a routine to monitor not to loose hearing in myleft ear. I have a sore face/sinus on myleft side today and I stay worried, whatever caused the right sid e sensorineural hearing loss will happen to the left.
Hi Donna:
I take it you had sudden sensorineural hearing loss in your right ear some time in the past and you are now worrying that it will do the same to your left ear in the future.
Let me set your mind at ease. It very seldom happens to the other ear, even though theoretically it can. So you only have a very slight chance of sudden hearing loss occurring in your good ear.
Also, if that ever did happen, all is not lost. You can get cochlear implants. Typically, you’ll get most of your hearing back when you are wearing them–so you’ll not be left deaf for the rest of your life.
What caused your sudden hearing loss–a virus, blood clot, ototoxic drug, or what? Do you know?
Normally, you’d go to an audiologist to monitor your hearing. But trying to predict when sudden hearing loss might occur is largely a waste of time, for things such as viruses and blood clots in your inner ears. If you are taking drugs that cause hearing loss, typically the hearing loss is not sudden but your hearing drops over a period of weeks or months or years–depending on the drug.
Cordially,
Neil
So I had a infection in my right ear and I put little drops of hyrdrogen perixide and it was fizzling . Then I waited a week and tried to open it up and it opened up . Then about 4 days after it felt like it was closing so I did the same method when I tried to open it in the first place . And it closed and went numb on me . I can hear but it feels clogged and I just need help what I need to do .
Hi Olivia:
I’d have your doctor have a look and see what is going on.
Cordially,
Neil
I’m a little shocked that ENTs only spend about 5% of their time on ears. I understand that most sick people have issues with their nose and throat. Still, I swear that my kids have ear infections all the time. Perhaps my family is the exception to the rule.
Hi Jesse:
Numbers of them do, but some have practices more geared to ears so they should be more knowledgeable about ear conditions.
If you kids have ear infections all the time, you should investigate why? Are they getting too much sugar and thus shooting their immune system down? Are they not getting enough vitamin D3? Are they eating too much junk food? Just addressing these three issues could make all the difference.
Cordially,
Neil
Thank you for this information.
I have clogged ears but no pain. I am having imbalances issues bad. Not vertigo more swaying. Also some days nausea. About to lose my mind
Hi Jennifer:
Clogged meaning full of fluid, or is it a blocked or feeling of fullness in your ears? The former can be because you have a cold or allergies that also clog your sinuses. The latter can be because the nerve that controls your Eustachian tubes is “pinched” so signals don’t flow freely up and down it. If this latter is your case, the professional to see is an upper cervical chiropractor. He can properly align the two top vertebrae n your neck and this will remove the pressure from this nerve.
Incidentally, vertigo doesn’t just have to be a spinning sensation. It can be a back and forth rocking sensation–is that what you mean by swaying? Note: this can also be due to your top two vertebrae not properly aligned. So seeing an upper cervical chiropractor may help you in more ways than one.
Cordially,
Neil
So I woke up Jan. 4th with no hearing in my right ear. Went to my primary Dr. the next day. They said fluid behind the ear drum. Started me on nasal spray and netty pot. Went back 2 weeks later because it was no better. Added Singular and Allegra, still said fluid behind ear drum. Wait to see. call back in a week if not better. Was not any change so they added another nasal spray Azelastine. Called the next week to let them know it was not better and please do a referral to ENT. I called with referral they said I had to see audiologist first then ENT (could do in same day) but could not get an appointment for 7 weeks. So my appointment was 4 days ago and I was told I have SHL and is irreversible. But they want me to do a MRI just to see if something else maybe going on. I was so upset. I felt like, since it was not being treated like a big deal, it would get better and to find out it was a very big deal and now I won’t be getting it back and to deal with it and the high pitch whistle that is constant. Would you recommend a MRI still needs done? Should I seek out another specialist? It will be 4 months with no improvement.
Thank you for any advise.
Hi Susan:
Your doctor sure didn’t treat you properly. He just assumed that you had congested ears and acted accordingly instead of doing the simple “hum test” to see whether it was a medical emergency or not. Now you have to live with his incompetence for the rest of your life.
Can you remember whether you had a cold, flu, or any other active virus in your body in the two weeks or so before you lost your hearing? If so, that would strongly indicate the likely cause was a viral attack on your inner ears. And if that was the case, then an MRI isn’t going to find anything related to your sudden hearing loss. If it were me, I’d forego the pleasure.
Since 4 months have gone by, and assuming you have a sensorineural hearing loss, then there is basically nothing doctors can do to help you at this late date. You should look into getting a hearing aid if that will help you–or maybe a special kind of aid called a CROS aid if you have no hearing on that side.
Cordially,
Neil
Can you help me please? About a year ago I had a bad ear infection that left me with very loud rining. I visited an ENT who had an MRI done. His finding was I had “thickening” behind by ear drum. No other explanation except to refer me to an otologist.
Have you ever heard of this? It had not gotten any worse but is affecting my sleeping and hearing as it appears I’ve lost about 50% of my hearing in that ear.
Hi Theresa:
I don’t know what he means by “thickening” either. When you have ear infections, you often get fluid buildup in your middle ear, and that fluid can thicken into what I call “gunk” and this makes it hard to drain out through your Eustachian tubes. The result is that you have some degree of conductive hearing loss because the bones in your middle ear can’t vibrate freely with all the think gunk there. An analogy would be to try clapping your hands underwater as opposed to clapping them in the air. That’s the difference.
Normally this “gunk” drains out over time. It may take a few months after the infection is gone.
Cordially,
Neil
After reading these comments I realize it’s probably too late for any corrective treatment but perhaps you can give me your opinion. It’s been about a year since I awoke to substantial hearing loss in my left ear. I saw my primary care doctor and she just checked it with her light and didn’t see ear wax so she suggested ear drops. I also tried a neti pot. I always believed it would just go away but nothing changed. I then saw an ENT after about 5 months and he just suggested hearing aids. I don’t believe I ever had any type of infection. I also have experienced spinning a few times. Recently I flew on a plane and my ear seemed to open up for about 4-5 days. Would it be worth my effort to see an Otologist or a chiropractor in your opinion, out should I just learn to live with this condition.
Hi Karen:
If you just had sudden sensorineural hearing loss, then I’d say it’s far too late to take any positive action. However, you have two things that make me wonder whether you don’t have a different problem, or maybe another problem.
The first is that your ears seem to open up for four or five days after flying on a plane. If the problem was normal sudden sensorineural hearing loss, you wouldn’t hear any better after flying on a plane because the hair cells would be dead, thus causing your hearing loss. This makes me wonder whether you have a Eustachian tube problem, maybe in addition to your sudden sensorineural hearing loss.
The second thing is that you have experienced vertigo a few times. Periodic episodes of vertigo lead me to believe that maybe an upper cervical spine chiropractor would be your better choice.
You see, vertigo could be caused by your neck being out of whack, pinching your eighth cranial nerve and resulting in vertigo, and also pinching your fifth cranial nerve which is your trigeminal nerve. This can cause your Eustachian tube not to function properly.
So I think it would be worthwhile being checked out by an upper cervical spine chiropractor first to make sure that your head and neck are properly aligned. Then, if your symptoms go away,, you know that was the problem. If it doesn’t make any difference, then it’s time to look at other things. At that point perhaps going to an otologist would be your best bet.
Cordially,
Neil
Neil,
What can an ENT or otologist do in the first few days or weeks after onset of SSHL? I woke up deaf in one ear just over 2 weeks ago. I immediately went to a doctor, and saw an ENT as soon as possible which was 5 days after onset. They did a full audiology test and diagnosed as SSHL. The only treatments suggested were oral prednisone and transtympanic predinisone & they did both. I started pred immediately after onset. None of this has helped yet. I’m trying very hard to get an appointment with a neurotologist; there is a 2 – 3 month wait to see them, and the one I’m trying to reach wants to wait to see if there is improvement in 3 months. I;m doing an MRI in a few days. I’ve read lot of literature on this. Valacyclovir has been used but is not recommended in this case.
The increased tinnitus and sensitivity to even mild noise are driving me crazy!
What else can a specialist do, especially quickly? Fortunately there are several specialists my area but they have long wait times.
Hi Alexander:
Your ENT gave you the standard treatment for sudden sensorineural hearing loss. Sometimes Prednisone works and sometimes it doesn’t. Unfortunately, in your case, it doesn’t have seemed to work.
Using an anti-viral is only recommended if you have an active viral infection in your body. Apparently your ENT doesn’t think you do so didn’t prescribe one.
Thus, you are basically out of options for a medical “fix” as near as I see it. However, there is one thing you can try and see if it will work–but you’ll have to start now as the window of opportunity for this treatment to work is fleeing. And that is constraint sound therapy.
You can read about it at http://hearinglosshelp.com/blog/constraint-induced-sound-therapy-for-sudden-sensorineural-hearing-loss/ and see if it will work for you. It’s something you can do yourself. If it doesn’t work, you probably have a permanent hearing loss that nothing will correct.
You didn’t mention how severe the hearing loss was. Since tinnitus almost always accompanies sudden hearing loss, you have to learn how to effectively deal with your tinnitus. My book on tinnitus at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ will help you since most effective tinnitus treatments work largely due to your efforts–not what a doctor or audiologist does.
I’m not sure whether you have hyperacusis as a result, or if it is recruitment. In any case, normal sounds can be (or become) much too loud. There are treatments for this too–but they take time and work on your part also.
Let me know what your audiogram shows for you bad ear.
Cordially,
Neil
Thank you so much Neil.
My bad ear is down about 100dB for most frequencies, a bit less attenuation at higher frequencies (perhaps 50dB, I don’t recall) with an average of 87dB. In practice I can’t hear anything in that ear unless it’s loud enough that it hurts, and then it’s more like a buzz than normal sound. I am very hesitant to boost sounds enough to be “heard” by that ear since when I can hear anything from it, it hurts.
The loss happened over two weeks ago.
I really appreciate your pointer to Constraint Induced Sound Therapy. As it happens I have been wearing an earplug a lot in my good ear, mostly because it’s vastly more comfortable that way, and also I have been concerned about the unfortunate effects of neuroplasticity in my case. The brain’s adaptation seems to make things worse rather than better.
It seems to me that the tinnitus in my bad ear got louder after the SSHL.
My main problem now is that almost any sound, including that of my own voice, in my good ear, makes my head hurt and makes me feel bad overall. And exposure to sound seems to make the tinnitus worse in my bad ear. Hence I avoid sound as much as possible and use an earplug. I can hear people talking through the earplug if it’s clear enough.
I am *very* interested in any information about how to deal with the new noise sensitivity, whether it is hyperacusis or recruitment. Is recruitment part of neural reorganization? It feels like it is.
Hi Alexander:
It’s a real pain (pun intended) when your recruitment is so bad that by the time a sound is loud enough to hear, it is already too loud to stand.
You would expect your tinnitus to get worse in your bad ear after the SSHL. When sound makes your tinnitus worse, you have reactive tinnitus.
Did you read my article on recruitment at http://hearinglosshelp.com/blog/recruitment-from-hearing-loss-explained/ ? Recruitment is the result of your collapsed dynamic range–so sounds get too loud too fast. I don’t think it is really part of brain plasticity.
Cordially,
Neil
Thank you Neil. I read your article on recruitment and some others of your articles.
I bought your e-book Take Control of Your Tinnitus. I’ve already skimmed much of it and found it very helpful! I highly recommend it to anyone who has tinnitus.
Recently, a friend of mine had a carotid endarterectomy. Upon awakening from the surgery, she could no longer hear out of her right ear, (the side where she had the surgery). Her surgeon did not evaluate the ear and just told her to follow up with her primary care doctor in a few days. She did as instructed and the primary care doctor started her on antibiotics which, of course, did nothing. After a visit to an ENT and an Audiologist, she was diagnosed with severe SNHL. When my friend asked the surgeon if it could be a result of the surgery, he told her that it was not possible. I did a little research on the topic before her office visit and I went with her. After he said it was not possible I asked, “so, vascular insult could not have caused her hearing loss?” and he emphatically said “no”. How can he be so certain? I’m far from an expert, but if the blood flow to the ear comes off the same artery as where she had her surgery. And, that blood flow is highly vulnerable to any change in pressure, would that not be a plausible explanation? Also, if you know of any research articles on this topic, I would really be interested in reading them.
Hi Lisa:
I’m with you. If blood supply is interrupted to the cochlear artery, then hearing loss can be the result. I’m not a medical doctor so don’t know all the ins and outs of where the cochlear artery gets its blood supply, but this is where it comes from. “The labyrinthine artery which is an end artery supplies the inner ear. This is a branch of anterior inferior cerebellar branch of internal carotid artery.”
So it is entirely possible that there was an interruption of the blood flow during the operation, or even possibly a mini-stroke from a tiny clot lodging in the inner ear. That’s one possibility.
Another likely possibility is that the drugs they gave your friend were ototoxic and caused the hearing loss.
Or it could be a combination of both.
Cordially,
Neil
Neil,
Last February I had a sinus infection that resulted in fluid in my ears. My PCP prescribed an antibiotic, which didn’t help, so then tried another one, also no help, then a steroid. During this time I realized that I had significant hearing loss in my left ear. Then I went to an ENT. This doctor prescribed another antibiotic, sinus spray, allegra D, sinus rinse, and a hearing test. The antibiotic didn’t help, the hearing test confirmed that I had significant hearing loss in my left ear, which I already knew. Apparently the doctor does not see any fluid so is treating it as Eustachian tube dysfunction. I have had a sinus CT, an MRI and allergy testing. It has been 5 months and I feel like they are on a wild goose chase trying to relate this to sinus problems or allergies. It seems like they are missing something, and meanwhile I am very concerned about the loss of an important life function. Aside from not being able to hear well, at times I hear a white noise sound so loud that it is disrupting the hearing in my good ear. When i was on an airplane recently every time I swallowed my hearing seemed to change, I have been told to try to pop my ears, which I do several times a day with no success. The other morning I had a very profuse nose bleed (something that in my 60 years has never happened to me before) in the same side of my nose as the hearing loss. Seemed like something strange but when I called the doc, they didn’t seem to think it had anything to do with my problem. Meanwhile I am very frustrated and am not sure that the chemical sinus treatments I am receiving are going to ever help me get my hearing back. My allergies are minimal as far as I am concerned, I just want to be able to hear again. Should I start over at an ear specialist? The ENT that I am seeing is very highly recommended, but maybe hearing loss is not their specialty. Any advise you have is greatly appreciated.
Hi Maribeth:
If you don’t have allergies or sinus problems, yet you can’t pop your ears, then that might be due to Eustachian tube malfunction.If that is the case, one cause of Eustachian tube dysfunction that I doubt your doctors know about is the nerve that controls your Eustachian tube is pinched so it doesn’t send the proper signals. This is the fifth cranial nerve (trigeminal nerve).
If this is the problem, then I’d go to a special kind of chiropractor called an upper cervical spine chiropractor and have him check that your C1 and C2 vertebrae are in proper alignment. Sometimes that’s all it takes. You can read more about this in my article on Meniere’s disease at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ . One of the symptoms of Meniere’s disease is a feeling of fullness in your ear (and this is due to Eustachian tube dysfunction as I mention).
That’s what I’d do first if I were in your shoes since nothing else has worked up to this point.
Cordially,
Neil
I’ve suffered from hearing loss and worn hearing aids for about 10 years. Earlier this year, after a hearing test, my audiologist discovered word recognition in my right ear had dropped from 86% to 25% in 2 years. I got an MRI done and there was some white matter, but I never followed up with a neurologist. Since then (10 months), my hearing in my left ear has dropped precipitously, so that I now only have 22% word recognition in my left ear also. The neuronotologists in my area have waiting lists of 6 months. Should I see a neurologist that doesn’t specialize in hearing loss if I can get an appointment sooner? I have a low red blood cell count and have had iron infusions to treat severe anemia. Yesterday I had a blood test to check for folic acid, iron, and B12 to help identify blood chemistry issues related to hearing loss. I am also concerned about damage to myelin sheaths that may have resulted from use of Welchol. I would like to find a specialist who can correlate all this information holistically and offer a diagnosis/treatment plan, but I don’t feel I can wait 6 months!
Hi Karen:
That’s quite a drop in word recognition in just 10 months. How much did you hearing drop in the same time frame? Often word recognition scores drop as hearing drops, but it is not a given.
What drugs have you been on? Many drugs can cause hearing loss. If that is what is causing causing your hearing problems, you want to get off the culprit as soon as possible to stop further deterioration in your hearing and word recognition.
I sure wouldn’t want to waste time waiting around for 6 months just to see an oto-neurologist. Even getting some answers now is better than nothing.
Cordially,
Neil
Hi. Could you please share commonly prescribed drugs that impact hearing? I started to lose my hearing in my early 30’s and after seeing two different ENTs, I was told I might have Meniere’s. My last audiogram was in Sept 2017 and I lost another 15%. A second MRI this past February once again revealed nothing. My audiologist states, “maybe it’s just genetics”
I had many ear infections as an infant up until about 5 years old. I’m told I don’t have any scar tissue in either ear. But I have been on various medications specifically very strong antibiotics for MRSA, pneumonia, strep and pharyngitis. Not to mention a slew of medications to treat IBS, asthma and allergies.
A friend suggested that perhaps since no one can find anything wrong with structure or function that it’s neurological – I’m not processing sound correctly.
Thoughts?
Thanks in advance!
Hi PZ:
There are FAR too many drugs that can cause hearing loss to list them here. There are hundreds and hundreds of them. To be sure, some are more commonly prescribed than others, bu there is still a lot.
Antibiotics as a whole can cause hearing loss. If you list the drugs you have/are taking for your various conditions, I can tell you whether they are likely to have caused your hearing loss.
Your hearing loss may be genetic or due to other factors, but I strongly suspect it is due to the many ototoxic drugs you have taken over the years.
Another thing. When you have hearing loss, vertigo, tinnitus and a feeling of fullness in your ears, your doctor immediately thinks of Meniere’s disease, and never thinks that all those side effects could be caused by the drugs you are/have taken. That may not be Meniere’s disease at all, but rather drug damage.
Cordially,
Neil
35 years ago I was hit in left temple. I went to local MD who said I may have Meniere’s but hearing should return in left ear. No such luck. Since then, I have had hearing checked by MD and audiologist twice and now down to almost no hearing in left ear. Sounds from the test hurt my hear. No testing other than hearing sounds by audiologist was ever ordered. Due to long time ago injury, do you think seeing a hearing loss specialist would help?
Hi Mitzi:
Why did you doctor think you might have Meniere’s? Did/do you have fluctuating hearing loss, tinnitus, periodic attacks of vertigo and a feeling of fulness in that ear? Those are the classic symptoms of Meniere’s disease.
The test sounds may hurt indicating that you either have recruitment (from the hearing loss) and/or hyperacusis from the ear trauma.
Tell me more about getting hit in the temple. Were you knocked out? Did it affect your neck and make it tight? Did it instantly affect your hearing? tinnitus? etc.
The answers to all these questions can help me decide whether you should go to an ear specialist or not.
Cordially,
Neil
Baby stroller was not secure and I got hit when I let go. I was not knocked out and no tight neck. I do remember ringing in ear and vertigo. I do not remember if I had instant hearing loss. I was told that hearing should come back and it has not. The hearing has gradually gotten worse. I do not know and cannot comment on fullness in ear. Thanks for your time.
I didn’t know that an ENT spends probably only 5% of his time with ears, that is a surprising statistic. My son keeps getting ear infections and my daughter gets tonsilitis, so I have been thinking that we might need to go to a specialist. I think I will have look more into an ear nose and throat surgeons in my area.
Hi Jenna:
The 5% figure doesn’t apply to all ENTs, so look forone that really treats ears more than the other problems.
Cordially,
Neil
Wow, I never thought that ENT specialists don’t necessarily mean that they work all the time with ears. Like you said, they only work with that part of the body for about 5% of the time only, but they usually handle the middle ear and its infections. I will keep that in mind that I should seek an ENT specialist when I go to a hospital first thing in the morning tomorrow to get my child checked. My son just complained about the pain that he is having in his ears. I’m not sure about the cause or the problem, but I have a feeling that there is something that happened during his camping retreat with his classmates this weekend which he won’t share. Thanks for the information!
Are ear tubes safe? Antibiotics are not working for a while and have recommendation of ear tubes and wanna make sure if its safe or not.
Hi David:
If you have middle ear infections that don’t go away and are pushing your ear drums out, ear tubes can be a good solution until the infection goes away. They are probably a lot safer than letting your eardrum rupture. Over time they typically fall out by themselves and your ear drum typically heals up again.
Cordially,
Neil
In Jan. 2017 I was diagnosed at a Minute Clinic with my first-ever ear infection at age 69. I was given a course of antibiotics and the pain dissipated, but was left with a fullness in my ears. In March I was seen by an Otolaryngology specialist who, after a 360 degree head scan, diagnosed me with severe sinusitis, and prescribed another antibiotic. This did not help. In June 2018, I was seen several times by a Neurotologist who, with my permission, punctured my left ear drum in an effort to alleviate the fullness, I guess thinking there was fluid, but there was not, and it did not help. He sent me for a CT scan that revealed “very subtle inflammatory exudate in the lateral mid aspect of the left mastoid compatible with acute or chronic mastoiditis, no significant acute, air-fluid level, or additional abnormality seen in either mastoid, there is anatomical variant to light distortion of some of the intermixed bony septa bilaterally with no frank significant bony destruction, the visualized portions of the bilateral middle ear ossicles are normal, external auditory canal is normal” Conclusion: very minimal acute and chronic left mastoiditis with small porteinaceous and inflammatory debris seen. The Dr. did not give me any course of treatment for this condition instead, he verbalized my problem may be due to TMJ and suggested a dentist for further analysis. At both of these doctor’s visits I had hearing tests by their audiologists. Those tests revealed a hearing loss over this time, particularly at higher pitch. It is now Oct. 2018, and I feel the problem is getting worse. The stuffiness in my ears now is beginning to produce a sort of “white noise”, and I’m finding myself saying “what did you say” to those I am around daily, although I would characterize my hearing ability at “fair” overall – I can still hear from both years on the phone and with TV, but cannot “clear” either, and am at a loss as to what to do next. I feel as time goes on I could completely lose my hearing.
Hi. I appreciate if you could give me some advice.
I got sudden hearing loss this morning (Saturday) and the otologists are closed on weekends. Should I wait until Monday and call the otologists? Or do you think it is worth going to the urgent care tomorrow (on Sunday)?
Hi Marina:
I’m a little late to be chiming in now. But you didn’t give me any details to work with, so I can’t make any recommendation.
If you had the sudden hearing loss in one ear, that is different than if you had it in both ears. With one ear, you can do the “hum test” and know whether it is an emergency kind of problem as opposed to something that can wait. Search for “hum test” on the centers website to find this article and how to interpret the results.
Cordially,
Neil
Hi. I have been having muffled hearing In one year on and off for years. I now have swollen lymph nodes also surrounding the ear. I went to an ENT today and he basically said nothing is wrong with me after looking in my ear and running some tests. He also said not to come back unless it gets worse. I came today because for the last month the muffled sound is happening more frequently and lasts longer. He says my hearing is fine. Well it wasn’t muffled today. I’ve been to my primary and a minute clinic also and no one will listen. With my insurance I can’t see anyone else with out a referral and they are giving me such a hard time at my primary and want me to make an apt to come in there again before they will help me any further. I’m at a loss.
Hi Kate:
You’re the first person I’ve come across that has the same name as my paternal grandmother. (Just interesting.)
I don’t have any wonderful insights into your muffled hearing from what little you have told me. So I need some answers to my questions to see if anything pops up.
First, what “events” are associated with this muffled hearing? Anything you can think of?
How many years has this been going on for? What happened before you had it the very first time–can you remember? One possibility is exposing your ears to loud sounds–say a music concert, loud game, etc.
Did you begin taking any drugs just before it began? Are you on any drugs now? Some ototoxic drugs can give you this muffled feeling.
What makes it go away? Does swallowing or yawning?
Is this muffled feeling the only ear problem you have (or had)?
Feel free to add in any other information you feel might be relevant.
Cordially,
Neil
Hi, I was standing in front of cooktop with vent fan on for 90 minutes helping my wife in cooking. After we finished cooking, I started experiencing ringing sound in my right ear with sudden hearing loss. Went to urgent care where they referred me to ENT. After two days I also started experiencing dizziness and vomitings. I consulted ENT where they conducted audiogram and tympanogram tests and told me that it’s sudden sensorineural hearing loss unilateral right ear with unrestricted hearing on the contralateral side and prescribed Meclizine 25 mg, prednisone 25 mg, ondonsetron 4 mg disintegrating tablets. And ENT also suggested 1.brain MRI with and without contrast, 2. Physical therapy evaluation . After taking prescribed medicine dizziness and vomitings resolved but hearing loss with ringing sound (tinnitus) still persists. MRI and physical therapy evaluation reports are normal and went for ENT review along with reports but ENT doctor says there is no further treatment for this. Need your advice sir. Thanks in advance.
Hi Praveen:
What I suspect happened is that you had a viral attack in your inner ear that affected both the cochlear (hearing) side and the vestibular (balance) side. Thus both the hearing loss/tinnitus and the dizziness/nausea.
Did you have any active virus in your body at the time or in the two weeks prior to this event? If so, that could be the cause.
Whether you can do anything effective now depends on how long ago this occurred. If it was only a day or two ago, then there are things you could have done–but from what you say, I think it was longer ago than that.
The Prednisone at 25 mg seems low to me. Normally, you’d have a tapering dose beginning at 60 mg or so and reducing to nothing over 10 days or so.
I don’t know why you were given Ondansetron? If your doctor suspected a virus, normally you’d have been given an anti-viral at the same time.
You don’t say how bad the hearing loss was. My rule of thumb is that the worse the hearing loss, the less chance of getting back a significant amount of hearing. And if no hearing has returned by now (assuming it was more than 2 weeks ago), I doubt anymore will come back.
So if my assumptions are true, I’d agree with your doctor that they don’t know anything more to do to treat it.
Cordially,
Neil
Thank you so much for your reply sir. It’s been 6 weeks and the hearing loss is about 80 to 90 percent and no improvement so far. I also have an appointment with Neurotologist on March 3, 2020. Can you please suggest me what are the options I have? Thanks in advance sir.
And also please suggest me how to manage this continuous ringing in my right ear? Thanks in advance sir.
Hi Praveen:
Wearing a hearing aid is one good way to help get your mind off your tinnitus. Some hearing aids also have tinnitus programs (noise generators) built in. Setting the white noise to a level a bit softer than your tinnitus is a good strategy. You can use other sounds such as pink noise, fractal music, or environmental sounds such as various water sounds–waves lapping on the beach, waterfall sounds, babbling brook sounds, rainfall, etc. Pick a sound that doesn’t grate on your nerves. Water sounds typically help sooth you so are a good choice.
You also don’t want to focus on your tinnitus, nor think of your tinnitus as a threat to your well-being. If you do this, it will get worse and won’t fade away. However, if you think of your tinnitus as just another useless, unimportant background sound that you can safely ignore, then over time it will tend to fade into the background and not bother you. This is called becoming habituated to your tinnitus.
Cordially,
Neil
Hi Praveen:
Since so much time has gone by, I don’t foresee any hearing coming back. So your basic option is to get and wear a hearing aid in that ear unless your discrimination score in that ear is so poor that wearing a hearing aid would make it harder for you to hear and process sounds in your good ear.
Cordially,
Neil
I am week 3 of ISSHL. Steroids shave not worked. I was looking into HBOT, but ENT won’t give orders just yet. Do I still have time to get treated and recover fully, if I go see a Neurotologist?
Hi Elizabeth:
After 3 weeks HBOT won’t have very good results as compared to starting it a day or two after the hearing loss. I don’t really think it is worth it now. You can see what your doctor says.
If you have not had any hearing return in the past three weeks, then I doubt that any or much will return. Typically, if hearing is going to return, it starts within 3 or 4 days.
Cordially,
Neil
Hi, Neil – I had the flu in Jan 2023 and took Tamiflu immediately, but noticed my hearing was blocked in my left ear. I went to my PCP in Feb and he gave me steroids for 5 days. I saw an ENT in March and she removed ear wax and said that I may have otosclerosis and to come back in 6 months for another hearing test. I went to an Audiologist in June to see if I could get a hearing aid, but he said I have skin on my ear drum which should shed off. I went to a 2nd ENT in August and he removed skin from my ear drum and said I should be cured. I didn’t have any improvement so I went to a 3rd ENT yesterday. The audiogram showed borderline/mild SNHL in both ears at the low to mid frequencies. Thresholds are symmetrical except left ear is 10 DB worse than the right at 2K hertz. The ENT said there was nothing wrong with my hearing and if it bothers me, to just ignore it. I feel something is wrong, but don’t know what to do. When I do the hum test, the hearing in my right ear goes in and out. I recently had my tooth fixed, and the drill noise was almost unbearable in my head. When I brush my teeth with my Sonicare, the noise is also very loud in my head. Am I just very sensitive? Can you please give me some advice? Thank you, Ann
Hi Ann:
The flu virus can cause hearing loss and tinnitus among other things. So can Oseltamivir (Tamiflu). Thus, at this point it’s difficult to say exactly what caused your hearing loss.
You don’t have otosclerosis like one ENT suggested might be the case as your audiogram shows sensorineural hearing loss. With otosclerosis, I’d expect to see some indication of conductive hearing loss.
Your hearing is not normal, but is “near-normal”. That is why you notice you can’t hear as well as you used to.
The hum test isn’t reliable when you only have a very mild loss and both ears have almost the same degree of hearing loss.
When you went to the dentist, was the drilling on an upper right tooth–where you heard the almost unbearable sound? And when you use your Soniccare toothbrush, is the noise louder when brushing on the upper right teeth?
Whatever caused your hearing loss (the flu virus or the Tamiflu) could have also made some sounds appear louder than normal (loudness hyperacusis). However, if that were the case, I would have expected it to have faded away by now. Are you an anxious or high-strung person? Anxiety can tend to make ear conditions worse.
Cordially,
Neil