by Neil Bauman, Ph.D.
Question: My mother suddenly lost her hearing. She never had any known ear illnesses before. What could cause this?—S. M.
Answer: Good question! Few things are so baffling (and scary) as waking up one day and finding your hearing is gone. Immediately you want to know what caused it, and more to the point, can anything be done to bring your hearing back.
Ear specialists tell us that sudden sensorineural (inner ear) hearing loss is one of the most perplexing and controversial unsolved mysteries about our ears. Since even they can’t agree among themselves what causes it, nor how to treat it, no wonder you are baffled. Here’s the latest on this subject.
There are two basic kinds of hearing loss. If the hearing loss occurs in the middle ear, we call it a conductive loss. If it occurs in the inner ear, auditory nerve or brain, we call it a sensorineural hearing loss. (The old term was “nerve deafness.”)
Sudden Conductive Hearing Losses
Sudden conductive hearing losses are relatively easy to diagnose and fix. The most common example would be the ubiquitous head cold. It may result in fluid build up/infection in your middle ears. Because the little bones in your middle ears can’t move freely in the fluid like they do in air, you don’t hear as well. You likely also feel pressure in your ears or your ears feel “plugged up.” This condition normally affects both ears at the same time. Fortunately, when this fluid drains out your Eustachian tubes (which may take up to several weeks), your hearing returns to normal. This kind of hearing loss is quite common, especially in younger children, but is not normally a serious problem and is certainly not a medical emergency.
More serious could be a blow to your head, or a sudden loud sound like an explosion that could dislocate/break the tiny bones in your middle ear. You need to go to your ear specialist at once. Your ear specialist can often repair this damage through surgery and your hearing returns to normal or near normal again.
Sudden Sensorineural Hearing Loss (SSHL).
Sudden sensorineural hearing losses (SSHL) are medical emergencies. You need to see your ear specialist (preferably an otologist or neurotologist) immediately (not your family doctor—he is not qualified and it wastes precious time you don’t have).
By definition, you have SSHL if you have a hearing loss that occurs within three days (often within minutes or an hour or two) and your hearing loss is greater than 30 dB over three adjacent octaves (test frequencies) as shown on your audiogram.
About one-third of the people with SSHL discover their hearing loss when they wake up in the morning. They go to bed with normal hearing, and in the morning they realize they are deaf in one or both ears! Fortunately, SSHL only affects both ears about 2-4% of the time. Other people discover their loss when they go to use the phone and realize they can’t hear the phone with one ear any more.
SSHL may be almost instantaneous. In such cases, you may notice a loud sound or a loud “pop” just before your hearing disappears. You will also experience dizziness or vertigo 50% of the time and tinnitus (ringing in your ears) about 70% of the time. Incidentally, the intensity of your vertigo often roughly corresponds to the degree of your hearing loss. You might also have a feeling of fullness in your ear(s) and a headache.
How common is SSHL? It varies, but the average seems to be that about one person in 10,000 experiences SSHL in any given year.
Causes of SSHL
SSHL is not a disease as such, but rather is the end result of damage to the auditory system from various causes. The sudden hearing loss is a symptom indicating that something has gone horribly wrong in your ears somewhere.
It’s rather interesting that although doctors have identified over 100 causes of SSHL, they can only identify the specific cause about 15% of the time. The rest of the time they call it “idiopathic”-of unknown cause. This is where all the mystery and controversy comes in.
Here are some of the causes of SSHL.
There are many drugs that can damage your ears (ototoxic drugs). Certain antibiotics, certain diuretics and certain anti-cancer drugs are particularly damaging to your hearing and can result in SSHL.
About 10% of the people getting Meniere’s Disease experience SSHL. Perilymphatic leaks (perilymph is one of the two inner ear fluids) can occur if either the oval (resulting in vertigo) or round window of the cochlea ruptures. These perilymphatic fistulas are what we think happens in cases of Meniere’s disease, from strenuous physical activity, straining or sudden changes in barometric pressure such as flying or scuba diving. Early surgical intervention to seal the leak may prevent further hearing loss and may restore some of the lost hearing.
About 10-15% of the people with an acoustic neuroma develop SSHL. (Acoustic neuromas are benign slow-growing tumors on the auditory nerve. Since they grow slowly, normally hearing loss is gradual.) Also other tumors such as cerebellopontine angle tumors can cause SSHL.
Trauma such as head injuries and temporal bone fractures can cause SSHL.
Circulatory problems feeding blood to your ears can cause SSHL. For example, lack of blood flow to your inner ears can result in permanent hearing loss in just 60 seconds. This could result from a partial or complete blood clot (a mini-stroke in your inner ear). SSHL could also result if your blood is too “thick” (the fancy name is hyperviscosity). You could get SSHL if your blood is too thin (from taking blood thinners like heparin), which causes internal bleeding in your inner ears; if the tiny blood vessels in your inner ears are destroyed (polyarteritis nodosa); if your blood clots too much or too fast; or if you have poor circulation from vascular sludge.
SSHL can result from deformed inner ear conditions such as Mondini syndrome, large vestibular aqueduct syndrome and labyrinthitis ossificans.
SSHL can result from immunologic diseases such as Cogan’s syndrome and Lupus and from various autoimmune conditions. An autoimmune condition that affects the cochlea is called Autoimmune Inner Ear Disease (AIED).
Viral infections are now thought to be the most common cause of SSHL. Recent studies show that this viral activity may be sub-clinical-meaning that it is not detected with standard clinical tests. According to one recent study, Herpes Simplex virus Type 1 (HSV-1) seems to be the most likely culprit. In animals inoculated in their inner ears with HSV-1, all the animals rapidly lost their hearing.
Other viruses thought to cause SSHL include adenovirus, cytomegalovirus (CMV), infectious mononucleosis, influenza, measles, mumps, parainfluenza, rubella and rubeola.
Miscellaneous causes of SSHL include endocrine disorders such as hypothyroidism and diabetes, exposure to pesticides, certain snake bites, encephalitis, leukemia, meningitis, multiple sclerosis and syphilis.
Treatment of SSHL
If you have a clear history of SSHL associated with diving, straining, altitude change (flying) or recent ear surgery, see your ear specialist immediately as surgery is often necessary to fix the problem.
If all obvious causes of SSHL are ruled out and your doctor calls it idiopathic SSHL, here are some things you should know.
About one third of the people with idiopathic SSHL recover completely without any treatment. Another third recover some or most of their hearing with treatment. The remaining third don’t recover any hearing whether treated or not.
You want to be in the first group for sure, but you don’t have a choice. Here is how to realistically tell what will likely happen in your case. Whether you recover your hearing to a large extent seems to depend on these factors. (These factors are not engraved in stone. If you happen to be in the “wrong” group, don’t lose hope. Your hearing may come back-just don’t expect it to. If it does, you can be pleasantly surprised.)
If you had a mild to moderate hearing loss in the mid frequencies (1,000-2,000Hz), you hearing will likely come back on its own within two weeks-whether you have any treatment or not. In other words, current treatments don’t work and are unnecessary.
If your hearing loss was profound (greater than 90 dB), you only have a 25% chance of getting your hearing back, regardless of the treatment you receive.
If your hearing loss was less than 90 dB and not limited to the mid-frequencies, then immediate treatment with steroids (within 10 days) has a 78% chance of restoring your hearing (or at least some of it). The only treatment that has proved effective (supported by double-blind trials) is corticosteroid treatment-usually Prednisone or Prednisolone. This generally works if you have a hearing loss in only one ear, your loss is a moderate loss across many frequencies and you are younger than 40.
Apparently this study was not entirely accurate since it was not randomized and thus may have produced exaggerated results. Furthermore, the study does not inform doctors what dose of steroids to use, nor at what time after treatment it expect improvement.1
Note that at the present time, there is no truly successful therapy for people with SSHL because even after treatment, you still will likely have considerable hearing loss. In fact, some ear specialists choose not to treat sudden sensorineural hearing loss at all, citing spontaneous recovery rates of 32-70%.1
Here are the various factors that seem to determine whether you will get your hearing back or not.
The severity of your hearing loss is inversely proportional to the rate of your recovery. This means that the milder your loss, the faster you will get your hearing back. Once recovery begins, it is likely to be rapid-in a matter of 7-10 days.
If you have vertigo, it tends to subside within one week and as a rule, all vestibular symptoms clear up within 6 weeks.
As a matter of interest, if you get tinnitus with your SSHL (about 70 to 85% do), it has no bearing on whether your hearing returns or not.
Studies indicate that the current practice doctors use—called the “shotgun” approach—giving steroids, vasodilators, diuretics, antihistamines, anticoagulants, carbogen, anti-virals, etc. and hoping that one or the other will do some good, was found to be no more effective than doing nothing at all! Only the steroids have been found effective in certain cases (described above).
No difference existed between people treated with antiviral plus steroids vs. placebo plus steroids, nor was there any difference between people treated with steroids vs. people treated with any other active treatment.1
So although positive results have been reported favoring systemic steroids, steroids injected through the eardrum, magnesium, vitamin E and hyperbaric oxygen, there are no randomized, blinded studies supporting the efficacy of any of these treatments. Therefore, at this time “sudden sensorineural hearing loss remains a medical emergency without a scientific understanding of its cause or a rational approach to its treatment.”1
Understanding as much as you can about SSHL helps take the fear of the unknown away so that you can better cope with it. On a positive note, doctors are making rapid advances in understanding what goes on inside our ears. As a result, they may shortly discover new and better treatments for this condition.
References:
1 Evidence lacking to guide treatment for sudden hearing loss. June 18, 2007. EurekALert. http://www.eurekalert.org/pub_releases/2007-06/jaaj-elt061407.php reporting on article by Elizabeth Conlin and Lorne Parnes in the Archives of Otolaryngology Head and Neck Surgery June, 2007 (133:573-581, 582-586).
I experienced SSHL in early May, 2016. However, my condition is somewhat unusual in that I lost the low frequencies but still hear the higher frequencies.
Nothing has improved my condition since the loss, although I received treatment with corticosteroids and anti-virals within 24 hours, later direct injection through the eardrum. Is there any hope to getting the lower frequencies back?
Hi Joe:
Since so much time has elapsed (more than 3 months), the chances are extremely slim that you will get any hearing back now. My rule of thumb is that the hearing you have after 30 days is what you will be left with.
At this point, you need to focus on successful hearing loss coping strategies so you can hear/understand the best you can with your low-frequency hearing loss. (And if a miracle does occur in the future–rejoice!)
Cordially,
Neil
Hello. I stumbled across this while researching the unilateral sudden hearing loss I experienced 14 days ago. I am in Latin America and it took a while to seek medical attention which I now realise has perhaps increased longer term risk by my delay. The doctor told me I have mild hearing loss in one ear though it feels like 50%. The higher frequencies are affected. Yesterday I drove out of the mountains from 2800m to 400m for 24hrs just in case it was a pressure/oxygen issue, to no avail. I am 7 days into a 16mg prednisone course also. I am in a bit of a panic now. Is a cortisone injection direct into the ear the next best idea or perhaps something else? It feels like pressure but no real pain. similar to temporary hearing loss while ascending on an aircraft, but it will not pass. Really would appreciate ANY kind feedback please…
Hi Sebastian:
Did you have any active virus in your body (cold, flu, herpes, varicella, etc.) in the week or so before your suddenly lost your hearing? If so, it could be a viral attack.
You have the typical high frequency hearing loss most people with hearing loss experience.
If the Prednisone isn’t helping you at all, then probably the injection into the middle ear won’t help much either.
The feeling of pressure or blocked feeling can be the result of your hearing loss and is then just a psychological feeling–not a real pressure build-up.
Did you have any feelings of imbalance or balance issues–dizziness, vertigo, etc when this happened?
Did your doctor suggest what caused this hearing loss?
If it was a viral attack and it is now about a month later, apart from the Prednisone, there is not really much else a medical doctor can do if your hearing does not come back.
Cordially,
Neil
Hello Neil
First, thank you for taking the time to respond. So, a little more information..
I traveled from staying at sea level in the English Summer first to Bogota at 2800 metres, then after 1 week to Medellin at 1500 metres and then after 1 week more I returned to Bogota at 2800m. I say this first as the changes of climate, let alone height, did bring about a cold. I find these tropical virus’s linger longer also, perhaps just the fact my immune system is not really accustomed. I would say the SHL came a week or two after the virus had just about dissipated, though I still had some mucus in my system.
I completed a course of oral Prednisole between days 8 and 17 after the onset. During this course I felt that I was not receiving the correct attention from the clinic I went too first, so I saw a doctor from another clinic to register this concern. He saw I had some rhinitis, either left over effects of the cold or perhaps some hay fever/pollen type allergy. He gave me the following:
1. Biogen Virex Z 800mg – Aciclovir
2. Nimotop Nimodipine 30mg
3. Nasacort AQ Nasal Spray – Triamcinolone
I believe the second may be a type of vasilodor to help with possibly hypoxia?
I began these other courses only after completing the oral prednisole, on day 18, out of concern about overloading myself with chemicals.
Regarding imbalance; around the time of the loss I may have been jogging shortly before and when I got off the running machine I felt a quick jolt of dizziness, but to be honest, when I exert myself at 2800 metres I figure its just my body trying to absorb the little oxygen there is around me so I’m really not sure this is associated. I do not over exert myself often, just light jogs and stretches by the way. Other than this I rarely feel unstable, considering the height at which I currently reside.
The doctor believed it was sensorineural rather than conductive hearing loss, though I do feel he was rather obsessed with the fact I used to play music at parties 20 years ago and my left ear was the ear for monitoring the sound. So he seemed to give up at the internal hairs being damaged. He may be correct, but I would have preferred a deeper exam and more open mind. He did not seem to consider the fact of environment change, my cold and possible allergy (though the latter is very slight as I am generally quite lucky with my health).
I have no knowledge of possible Herpes and I am yet to have an MRI scan.
Incidentally, about 5 years ago I experienced some very strange occurrences in both my ears but mainly the left ear, when in Medellin. It was not so much hearing loss but as if I was under water, echoey. At the time my ears, specifically the left, was very sensitive to loud low noises; I could not bear a low male bass voice near to my left side. I received no medical attention but I simply looked after myself well and after several months I seemed to get back to normal.
This time it is more of a loss of some mid the high frequencies, and the sound that does come in is rather confused. I am really hoping there is some liquid from an infection in there which will eventually dissipate, or that over time, if it is sensorineural, I can coax my hearing back, if you like, while generally keeping fit and healthy.
With all of this in mind, 3 days ago (day 22 after the loss), I received my first intratympanic injection, from the doctor at the second clinic (I have on on the first clinic). I also came to stay at my girlfriend’s family’s house in a town well outside and well below Bogota, at 400 metres above sea level, because I read some experiments about taking people with hearing loss at 2200 metres down much lower and some of them self corrected within 10 days at lower altitude. Hey, if I am fortunate to have these options it cannot hurt can it!?
Incidentally it is now day 26 since the loss and I am trying to relax while I try to recover.
I am 44 years old.
Sorry for the huge response but I wanted to include all possible information which may be relevant. Would really appreciate it if you have any further insight please Neil.
Thanks
Seb
Hi Seb:
In my experience, cold viruses don’t give sudden hearing loss right away at the outset of the cold, but later as the cold is going away. So from what you have said, I still think it might have been a cold virus that caused the hearing loss.
And the incident about 5 years ago also sounds like another manifestation of a virus when you get distorted hearing like that.
I’m sure that going from 2800 m to 400 m is a good thing (sort of like taking hyperbaric oxygen) which does help some people with sudden hearing loss. So it is worth the try.
You want to keep your immune system robust so such things don’t happen in the future.
Cordially,
Neil
My 13 years old daughter felt totally sshl 4mounths ago in her right ear doctor used direct injection in her ear but audiometry shows. At the low frequencies 200_1000 she is in 65 db and in high frequencies she is around 90 db. she can not distinguish words with right ear haw can l help her? I’m afraid for possibility of repeat this for her again in her left ear. Please help me. She is just 13 and i have seen in literature that sshl normally happens after30. what is the reason for my little daughter?
Is there any surgery to help my daughter or any invisible hearing device? because she doesn’t like to use any visible device
Is there any experience on repeating sshl for a person?
Hi Mehrabi;
Don’t worry to much about your daughter having a repeat of the SSHL in her other ear. It only happens rarely. SSHL can hit anyone–not just people 30 and up. There are a number of causes–but in your daughter’s case, it could have been a virus attacking her inner ear. Certain drugs could have also done this. Since your daughter is so young, it is unlikely that it was caused by a tiny blood clot in her inner ear–that usually only happens in older people.
Typically, there is nothing doctors can do to restore her hearing. Thus, either she learns to live with single-sided deafness, or she needs to get a hearing aid. Don’t worry whether the hearing aid is invisible or not–you need to get her the aid that will help her the most–no matter what it’s size. But most hearing aids today that fit over the ear are so small that most people never even notice them. I’m bald so I can’t hide my hearing aids and yet some people that know I’m hard of hearing look and my ears and ask whether I’m wearing hearing aids or not. They can’t even see them when looking for them.
One trick for single-sided deafness is to always sit on the side of the room (classroom) so her good ear is facing into the room. In her case, since it is her right ear, she wants to sit on the right side of the room so her good left ear can hear into the room. If she sits on the other side, her head will block a lot of the sound so she won’t hear as well.
And when she is out with family or friends, have them walk on her left side so she can hear them better.
Cordially,
Neil
Hello Mehrabi, I also have a 13 years old that in the 25th if December 2017 woke up with her left ear feeling clogged and start hearing different sounds and I took her to the ER at night, she was a little nauseated and some dizziness, they said Doctor .Oh she has fluid let’s give her Amoxicillin, no improvement another doctor change antibiotics ZPack and allergies and for nausea and dizziness, 3 weeks later finally went to audiologist and ENT same day he told us there was nothing to do she need it to learn to live with one good ear.. is been hard she miss a lot of school due to anxiety. Is getting a little better she plays in her school band . Hang in there!
Hi Neil Bauman,
I am 27 year old guy. I have been diagnosed with ISSHL . It happened around 10pm at night on 9th of January 2018. It started with a buzzing sound in the ear and then when I woke up at 3:45am on 10th, all I could hear from my right ear was a high pitched sound, tinnitus.
I was hospitalized at around 11 pm i.e 24 hours after it started.
I was given 1 gram of corticosteroids, along with vasodilators and antibiotics etc daily for 5 days intravenously . It had NO effect.
I was discharged on 16th with no change in hearing. PTA: 63-67Db.
Doctor performed myringotomy so I can put dexamethasone 4mg/1ml into my ear on my own, once or twice everyday. He also gave me 16mg tablets of methyl prednisone to be taken 3 times a day for first couple of days and then taper it to 1. (15 days course)
For the for first 12-13 days since the onset of SSHL, my hearing made almost no progress. From 13th day i noticed a very slight progress since I could hear my finger snap better. I started with HBOT on day 16.
I took a audiometry test after 2 days/sessions of HBOT and compared results with the report I had from day 6 when I was discharged. It turns out that my PTA has not changed . Its 63 (67 when i was discharged after 5 days). Hearing in 500,1k,2k remained unchanged. But I have recovered hearing in the range of 4k-8k by about 30-35db.
I will be taking another audiometry test tomorrow(day 21, after 5 sessions of HBOT). I am not sure about low frequencies but I think my hearing in high frequency has improved further. I am not sure if it has to do with HBOT or not.
Have done 5 sessions of HBOT (1 hours a day). Should I carry on with HBOT without gap? Should I stop and see if am still making progress?
Why have i made progress only in high frequency? Are parts in cochlea for sensing high and low frequency different? Do consecutive sessions of HBOT work better in theory?
Sorry if its too lengthy. Please do reply.
Regards,
Arbaaz
Hi Arbaaz:
I know the doctors put your hearing loss down to idiopathic hearing loss–meaning they don’t know what caused it, but sometimes there are clues. For example, did you have an active virus in your body anywhere–cold, flu, herpes, varicella, etc.? What you described sounds very much like it was a viral attack on your inner ear.
Were you taking any medications or drugs in the two weeks before this happened? Drugs can cause massive hearing loss, but not usually just like you described.
You only told me your pure tone average (PTA), but not your hearing loss by frequency. So I can’t answer your questions about frequency of hearing loss specifically to your case. Typically, hearing loss occurs more in the high frequencies than in the lows. For example, you might lose 20 or 30 dB in the lower frequencies, but 70 or 80 dB in the highs. So if hearing returns not much seems to return in the lows because you didn’t lose much in the first place. And it is in the high frequencies you want hearing to return because you lost so much there–and it is these high-frequencies that are critical to your understanding speech. The part of the cochlea that senses high frequencies is at the base, whereas the lows are at the apex. So the base is less “protected” than the apex and typically is more sensitive to hearing loss.
If the hyperbaric oxygen is helping, I’d stay with it until you don’t see any improvement (probably around 30 days or so, but it could be longer. HBOT isn’t used much in the US, so I haven’t seen much on the best protocol for using it.
Cordially,
Neil
I did have a cold but it was not major. As for medicines, I took Azithromycin about 1.5 months before this happened. My doctor too thinks that it could be viral.
My audiometry reports:
https://imgur.com/a/QBYVB
Please take a look. As you can see my hearing has improved in high frequency but low did not improve as much.
I started HBOT on 25th Jan.
I was supposed to lower my methylprednisolone dose from 32mg per day to 16mg from 29th onwards, But I did not because I am afraid that if I lower my dose it might hamper progress that I seem to be making with HBOT. I have decided to continue same dose for another 4 days and then reduce it. (I will be turning a 15 day course into a 19 –
20 day course). What are you thoughts?
Hi Niel,
I know you might be busy, but its important that I ask you this. I just noticed yesterday that if I cover my left ear(good ear ) with my hand tight in a quiet place I can hear tinnitus. I am scared that it might be a sign or something. Does this mean I am likely to get SSHL in my other ear as well? I don’t know if it was always there. I just noticed it yesterday. I don’t hear it until i cover my ear. Should I be worried?
Hi Arbaaz:
You don’t give me enough information to really say much. Do you have any hearing loss? Do you listen to loud music or expose your ears to loud sounds of any kind?
If so, the tinnitus may be associated with those factors.
You can put your mind at rest–tinnitus does not cause hearing loss. It is the other way around.
If it is so faint you almost can’t hear it, I sure wouldn’t worry about it at this point. But if there are other factors such as I mentioned above, or if you are taking any drugs or medications that can cause tinnitus–then you want to do something about these factors.
In any case, if you worry about your faint tinnitus, it will get louder and louder–so forget all about it and focus on the loves of your life.
Cordially,
Neil
Hi Niel,
I would like you to know that my hearing has improved to PTA 20db in my right ear. All frequencies between 250 to 8000 are less than or equal to 20db except 1000hz which is at 30.
I am able to hear with my right ear but the sounds are a bit distorted. There is a kind of echo , and clarity is not as good as my left ear. Could this be because 1000hz frequency is still lagging? Or could it be because I still have gourmet in my right ear which was placed a month ago through myringotomy ( so i can put steroids into ear daily at home). Or could there be any other reason? Tinnitus in my left ear has reduced a lot but it’s still there. Also can you please tell me if listening to loud music with earphones could cause SSHL? I had been listening to loud music everyday for atleast an hour for 4 months before SSHL happened.
Hi Arbaaz:
I’m glad your hearing is coming back at least to some degree.
I think the main reason for your distorted hearing/echo/clarity is from all the loud music you listened to causing some degree of permanent damage.
Listening to loud music can definitely cause hearing loss. The louder the sound and the longer the time generally determines how fast the loss occurs. So if you listened to really loud music for 15 minutes or more, you could notice a definite hearing loss when you get away from the loud music.
If you value your ears, you shouldn’t be listening to music much louder than the level that people talk. In other words no more than an average of 70 dB. But many people listen to music in excess of 100 dB and that’s a sure recipe for hearing loss.
Cordially,
Neil
Hi Niel,
Thank you for taking out time tovanswer my questions. There is just one more thing i wanted to confirm. My doctor says hearing loud music on earphones does not cause sshl. Its usually viral. Listening to loud music causes gradual hearing loss. Now that i have gone through all this i am scared to use headphones ever again but then headphones were a big part of my life. I used to watch movies , tutorials with headphones on everyday in addition to listing to music. I can give up music but giving up other things is difficult. My normal ear’s PTA is 13 and my bad ear has recovered to 20db. Except for 1000hz frequency which is at 30db.
Is it safe to use earphones/headphones to watch movies on phone etc? Given that i keep volume close to 60 percent? Or should i just avoid it at all cost? Also does in ear earphone restrict oxygen to the ear? I mean they kind create a vacuum in the air so does it mean they are dangerous because they restrict air flow?
Hi Arbaaz:
Your doctor is correct that NORMALLY wearing headphones/earphones dose not cause SUDDEN sensorineural hearing loss. The loss typically occurs slower over time. But it still can and does happen. For example, I know a lady who probably was drunk or on drugs and fell asleep with headphones one. Her “friends” turned up the volume while she slept and in the morning she had severe permanent hearing loss in both ears. Overnight hearing loss is considered sudden. She had normal hearing the day before this. So yes, headphones at loud volumes can cause SSHL.
Now to answer your concerns about wearing headphones/earphones/earbuds. There is nothing intrinsically bad about headphones that makes them worse than hearing loud sounds otherwise. It is the volume times the time you expose your ears to loud sounds that is the problem.
So if you keep the volume down, whether you listen via headphones or otherwise there shouldn’t be any difference in the results.
The real question is, “What is a safe volume for listening to anything?” And the answer is–listen to music or anything else at the same volume you normally hearing people talking. This is in the range of about 50 to 70 dB. So if you do this, you won’t damage your ears.
The oxygen your ears need comes via the blood flow to them–not down the ear canal. If it were otherwise, then all the people that wear hearing aids would have problems from lack of oxygen to their ear canals. Having said that, personally, I thin it is a bad idea to wear hearing aids all night long so your ear canals can’t breathe normally since they are blocked by ear molds all day. The same would apply to earbuds, etc.
Cordially,
Neil
I have had this same type of hearing loss in my Right ear that started back in January. My left ear already has greatly reduced hearing. I went right to the ENT who put me on high dose prednisone for 2 weeks. It cleared it up but it kept returning every few weeks and the steriods were really messing with me. After 6 rounds of steriods I starting looking for another option. I then went to a neuro otolaryngologist. We agreed to try the ear injections and I pretty good results without the side effects but still only getting a couple of weeks before it would dismiss again. Each time comes with anxiousness and worry that it may not recover.
Just recently I became aware of the work by Dr Joel Furhman who promotes fasting and heathy eating to cure many chronic illnesses. I decided to try a short 24hr fast the next time my ear lost its hearing. Within the 24h my ear returned to normal. About a week later it happened again and I fasted 24h and achieved the same result. About 10 days later it occurred again and I fasted for 42h. The hearing returned at 24h but I decided to go longer to see if it helps. I am only just over a day out. So I will see how it goes. In Dr Furhman’s book Fasting and Eating for Health, he recommends a physician monitored much longer fast, 2-3 weeks, to cure chronic illnesses. I may consider it but it is hard to plan that amount of time off. Hopefully I will good luck with the shorter fasts and heathy eating. I definitely like that I am achieving great results without the drugs.
Hi David. I am a great believer in general fitness, low toxicity for long term health. I am reasonably sure that the first time I had problems with my hearing that being very fit afterwards for 2 years (running 20km a week and very healthy diet) helped restore my hearing completely. I am pretty pissed off the doctor in my adopted country (Colombia) did not warn me about things like caffeine and salt (perhaps Dr. Bauman will comment about there here..) but to be honest I blame myself because I was going through a period of stressful work and taking a lot of coffee and although eating ok, not eating as good as I used to.
Fasting is a new idea to me, but has always been a feature in ancient cultures, so I will read up on it, though I think its just really about detoxing, don’t you?
Seb
Hi mi 13years old douther feeled totaly sshl 4mounths ago in one ear we begun direct injectin 4days she has problem infrequency upper than2000naw because the doctors didnt distinguish the cause of this and my dauther is very young i afraid this repeat in her other ear also he feels bad buzz inher ear could you please help me
Hi Raziyeh;
I’ve answered your questions in another comment. The buzzing she hears in her bad ear is called tinnitus. Tinnitus almost always accompanies sudden hearing loss like your daughter had. The best treatment for it is to focus on other things and thus totally ignore it. She needs to realize that it is just a noise and is not a threat to her well being. If she focuses on it, it will just get worse. If she learns to ignore it, hours may go by without her even realizing it is still there. Thus it won’t bother her much or at all at that point.
Cordially,
Neil
Hi Neil:
I suffered from viral encephalitis in February this year. I have a moderate low frequency hearing loss in both ears due to the encephalitis. What’s confusing is my tone scores are better on my left ear, but speech discrimination is much better on the right ear. Example: I cannot hear well using the telephone on my left ear. My neurologist and ENT assume the hearing loss is due to damage to the acoustic nerve from the brain swelling. Would that explain why my tone scores don’t line up with my speech discrimination on the left ear? I’ve scored 96% on the right and the left tested at 52% at the ENTs office then two additions tests of 88% and 92% when retested a couple months later at Costco.
Hi Anthony:
You would think that discrimination and hearing loss would go hand in hand. Thus the worse your hearing loss, the worse your speech discrimination–but that is not always so. You are a case in point.
I don’t know exactly why (and where) this happens. Maybe one day I’ll run across the reason.
Cordially,
Neil
Hi Neil
There is no reply button at the foot of your last missive so my response is coming further down the thread here…
You cannot imagine how much I agree with your response. First, yes the height change is my inexpensive version of hyperbaric oxygen and I figure with less risk attached. Second, so so glad you said that this is perhaps more likely to happen as the cold, if one has had one, is finally on its way out; certainly the case here (I am so annoyed with this doctor here – he is supposed to be one of the best in Bogota but from the outset I felt he was resting on his laurels as all he seems to want to do is show me his certificates on the wall and name drop about experts I have no idea about!! – I took my partner in for the last meeting without saying anything to her and she got up and walked out after 4 minutes!?). Third, we always hear about the importance of being fit, good diet etc., and I swear I am experiencing the differences very directly recently. Too much stress, too much caffeine, hardly any home cooking as I used to and no proper exercising. I am certain this is really significant, at least in my case.
I honestly believe I can get some of my lost hearing back over the next year if I get back to my good and healthy ways and stay there.
Thank you Dr. Bauman. I shall keep you posted!
Regards
Seb
…. I suppose the only paranoia I have is whether living at 2800 metres is really good for a person brough up at sea level, considering all of this? (We are moving to Spain in less than one year but maybe I should consider going sooner….??). Seb
Hi Seb:
Personally, I don’t see it as a problem. I was born and lived my first 35 years at sea level. Then I moved to a place at around 1000 m for 21 years, and I’ve been as high as 3000 m without noticing any ill effects (but I’ve never lived at that level–just short visits that high).
The only way I can rationalize that “high living” is a problem is that if you don’t get enough oxygen to your inner ears they get “sick” and don’t work as well. Thus your hearing drops. When you get more oxygen, they “revive” and your hearing returns.
When you add stress to that, the stress constricts your blood vessels even more, so you get less oxygen than before and make the situation even worse.
So maybe you want to get your stress under control and knock off any stimulants that constrict your blood vessels like coffee. Maybe you should eat some vasodilator foods and vitamins such as Ginkgo biloba and Vitamin B3 (Niacin) to relax your blood vessels and thus get more oxygen to your inner ears.
Cordially,
Neil
Hello Neil. I just read this last message. I shall try these vitamins thanks. Last week I returned to the UK to spend time at sea level and see a specialist here. My confidence took a bit of a blow because I had 2 intratympanic injections and the second one was extremely painful. Something must have gone wrong as I had pain for a few days afterwards. I really do not recall tinnitus to any significant degree before the injection but now, 4 weeks later, it seems quite a bit worse. I didn’t want to go back to any doctors after that so I just came to the UK. I saw the general practitioner this morning for a referral to the ENT people. Upon looking into my ear he said he could see blood. I saw 4 different guys in Colombia so either they all missed this or the last guy with the injection messed things up. He twisted the angle of my head when the needle was in my ear, which didn’t seem wise at that moment and it hurt, a great deal. I really hope he couldn’t have been silly enough to perforate my ear drum more that the needle would have done normally, or even damaged the bones within. Its hard being positive this morning, but what is done is done. Just not easy having confidence in professionals after the things which have happened to me this last 3 months. One rather odd development is this though: after I run, for a few hours, there is a feeling my ear is more open. The hearing isn’t really improved but there is less feeling of things being blocked. Also, if I berp after rehydrating myself, that air hurts my ear for that split second. This is only the case for a few hours after running. It is as if my blood flow or something has changed the situation temporarily. And one time when I swallowed and hummed at the same time I could hear my humming internally, for a split second, as if my hearing was 100%. It was quite startling. It’s all very odd and I am trying to link these pieces on information together, but its not easy. I try to look at these events as positive if we can make sense of them, rather that dwell on the idea that the last doctor damaged my ear. If any of this makes sense to you please say so. Thanks and all the best, Seb
My mother has had multiple infections and surgeries for her ear. She has severe hearing loss, and is only in her early 40’s. Are the doctors to blame, in that they did not properly treat her infections, resulting in more infections, and surgeries?
Hi Akshay:
There is no way I can answer that question with the limited information you gave me.
Some people are prone to ear infections because they have small ear canals, or poor immune systems, or have rebound infections from taking antibiotics. These kinds of things are not the doctor’s fault.
There are good doctors and not so good doctors. It may be that she has a not so good doctor that did mess things up, but I can’t know that.
Cordially,
Neil
Dr. Bauman,
Thank you for the clear information in this article and in your responses to questions.
I am in the middle of my third episode of SSHL:
-1st five years ago. LOUD cell phone ring woke me, followed by ear pressure and fullness in my RIGHT ear. Saw ENT one week later, hearing returned during course of oral steroids, step down from 80 mg.
-2nd two years ago, almost to the day. Woke with fullness in RIGHT ear. Went to ER and began oral steroids. Hearing returned within 48 hours of first steroid [step down 80 mg].
-3rd began five days ago in my LEFT ear, gradually worsening throughout day 1, improved throughout day 2, then intensifying evening of day 2.
Began oral steroids Monday step down 60 mg. I estimate 25% improvement in the past 18 hours.
What is known about multiple recurrences of SSHL?
Is an MRI a good idea based on the multiple episodes?
Many thanks in advance for your guidance.
Hi MaryAnn:
The first thing I’d want to know is whether the same thing is causing all 3 episodes so far. Was there something in common with all 3 episodes? For example, were you taking any drugs or medications at all three episodes? Did you have an active virus in your body at all three episodes–e.g. cold, flu, herpes, varicella, etc., etc.? Were you under particular stress at all three episodes? That may give you a clue as to what is happening. These things don’t just happen for no reason.
Did you have any feelings of dizziness, vertigo or imbalance during these three episodes?
What did you audiogram look like after these episodes–was it a high-frequency loss or a low frequency loss or a mid-frequency loss?
Is this recurring episodes of Meniere’s disease?
This is where I’d start.
Cordially,
Neil
I just experienced hearing loss in my left ear about a week ago. After teh 2nd day when it seemed worse I went to my doctor who sent me to an ENT. Hearing test confirmed I had acute hearing loss in my left ear. I have been on a 60mg prendnisone for a week with no improvement. I am frustrated, depressed and scared. I go back for an ear exam in a few days and I am guessing I will get the steroid injection. Reading all the various information does not make me feel any better as there are no real answers or treatments. I just seems like luck if you heal or not. It also does not help that I have had hearing issues since a child in my right ear.
I’m a 61 year old woman. 3 weeks ago I bent down and heard a pulsing noise in my right ear, it was like I could hear my heart beating very loudly. I then went totally deaf. Been to the ENT over here in England who carried out a hearing test which confirmed I was now severely deaf in that ear. Now waiting for an MRI scan. I have no vertigo, but dreadful tinitus now. Any tips on coping with this?
Hi Jane:
The pulsing sound you heard is called pulsating tinnitus and is caused by blood flow through a blood vessel close to your cochlea. Bending over increased your blood pressure and thus could be why you heard it.
Losing your hearing suddenly after that is unusual as far as I know.
Is your tinnitus still the pulsating type or not? If the former, then a good vascular surgeon can probably help you. If you tinnitus is just a loud steady sound, then it most likely has accompanied your hearing loss and may go away if your hearing comes back.
To help you deal with this tinnitus, you may find that wearing a hearing aid in that ear helps mask the tinnitus, or better yet, get a hearing aid with a tinnitus masker built in. In any case, it is important that you learn to ignore your tinnitus and focus on the loves of your life. You also need to understand that tinnitus is NOT a threat to your well-being in any way. As long as you consider your tinnitus to be a threat to your well-being, your body remains in fight or flight mode, and your tinnitus will not fade away. So treat your tinnitus like a totally unimportant sound–like the sound your fridge makes–and eventually you’ll not even be aware of it–just like you aren’t really aware of your fridge noise.
Cordially,
Neil
Thank you for getting back to me Neil. My hearing has not come back and the tinnitus is just one sound now. I’m finding it all very difficult to cope with and to top it all, couldn’t go through with my MRI scan today due to chronic claustophobia. They put this dreadful head thing on me that went over my face and clipped it onto the bed. Just couldn’t go through with it. Now worried I have a tumour with no way of finding out. NHS are not very sympathetic I’m afraid, but the girl in the MRI department said it might be possible for me to have a CAT scan instead? Worried sick that my hearing is going to go in the other ear. Regards, Jane
Hi Jane:
I find that if you just shut your eyes, you can’t tell you are in a confined tube. I almost fell asleep when I had an MRI. It sure helps to stay calm.
Just so you know, sudden hearing loss typically only affects one ear, and seldom goes to the other ear. So calm down and don’t worry.
And even if you do lose all you hearing in both ears, you can likely get cochlear implants and hear well again.
I’m functionally deaf and don’t let it bother me (at least not much).
Cordially,
Neil
Hi Neil:
Many thanks for your reassurance. It’s been very much appreciated. This forum has been so informative and helpful. Keep up the good work!
Kind regards,
Jane
Hi Neil!
It is nice that someone is answering these questions.
I had a very bad SSHL last October. 90 db hearing loss, severe vertigo, tinnitus, the whole package. After 8 days in hospital, and 1 month recovery at home, my hearing loss is better (25 db on deeper voices, 65-70 on higher), I got used to the tinnitus (people out there with tinnitus: you can easily learn to live with it! I couldn’t imagine it at first, but I have 60 db tinnitus and I don’t even notice it in most times).
My problem is the vertigo. By last December all of my vertigo went away, I was happy to go back to work. But from January it started to make episodes in every few week: at night if my head is turned in a bad way I have a very strong vertigo. Once it lasted half a day, last night only half an hour. My balance is also wobbly since January. It is far better than in October, but I am not sure on my feet (positive Romberg’s test).
My doctor is very helpful but she tells me that she has no idea why my balance is not healed.
I take piracetam and betahistine. I was on a dozen of tests: for infections including mumps, lyme, etc, rheumatology (I have a cervical lordosis but they say it doesn’t have to do anything with my hearing and vertigo), cardiology (pectus excavatum, but not so bad to cause these problems) and of course MRI for brain and inner ear (both perfect). My doctor is sure it isn’t Menerie as my audiogram shows opposite.
Could you suggest with your experience something for my vertigo? Or any other test we should run?
Thank you!
Mary
Hi Mary:
What was your hearing loss and balance issues from–a viral attack on your inner ears? To me it sounds like that was the probable cause.
When you have vertigo from turning your head a certain way, to me there are only two likely causes.
First is what is called benign paroxsymal positional vertigo (BPPV) where the tiny otoconia (calcium carbonate “rocks” in your inner ears get out of place and fall into your semicircular canals where they send false balance signals to your brain. Your brain’s confusion of these false balance signals results in vertigo.
The cure for BPPV is actually quite simple–go to an ear specialist and have him do the Epley Maneuver on you. It may only take one treatment, but sometimes more if they don’t get all the otoconia to move back into place in one treatment.
The second cause of vertigo is when your top two vertebrae in your neck are out of proper alignment. This is actually what happens in people with Meniere’s disease. And with cervical lordosis, I would almost expect that your C1 and C2 are out of proper alignment. It is easy to fix this too.
I suggest you investigate treatment from a special kind of chiropractor that specializes in the upper cervical spine (UCS). These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing such as vertigo and other issues.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
There is a lot of good information on UCS chiropractic on this page also.
So this is what I would do if I were you. In fact, I began having periodic episodes of balance/vertigo issues so last week I went to an upper cervical chiropractor to see whether it was my C1 and C2 that were off. He found that my C1 was 6 degrees off. He put it back in place. Now I’ll just have to wait and see whether I get any more of these vertigo episodes or not.
Cordially,
Neil
HI, I’m 17 years old and been suffering SSHL for about 4 years now, I went to a 2 different audiology. All they could say is that my case is unknown. My hearing level is mild to severe and also I’m a bilateral hearing loss. I am getting an MRI next month to see what’s going. I seriously give up.
Hi Jeanna:
You might want to get checked out to see if you have enlarged vestibular aqueducts (LVAS or EVAS).
Cordially,
Neil
Hi, I was wondering whether you could guide me toward a resource that supports “You could get SSHL if your blood is too thin (from taking blood thinners like heparin), which causes internal bleeding in your inner ears.” My husband is on a blood thinner (Eliquis) and recently experienced a sudden profound sensorineural hearing loss. Thanks. –A
Hi Andrea:
Sorry, I don’t know where I got that information. I wrote that six years ago now. I have no specific information linking Apixaban (Eliquis) with hearing loss, but I wouldn’t be at all surprised if it does happen.
Was your husband’s hearing loss in both ears or just one ear? Is he on any other drugs? Was there any other factors that might have been responsible for his hearing loss?
Cordially,
Neil
Hi Doctor,
My husband is now completely deaf in one ear after having a cold, the flu or allergies go undiagnosed for several days. He has had 2 does of different antibiotics and 2 doses of different strength steroids with no improvement.
At one point they diagnosed mastoiditis because his bone was so sensitive to touch, however the very next day the tenderness disappeared and has not returned. The hearing test revealed there was no fluid in his ears, but he said his head felt full of water.
My question is about imbalance. He can deal with the hearing loss, but he hasn’t been able to walk for going on 2 months. He doesn’t have vertigo or tinnitus, he sways like a drunk.
He is a police officer and he might be able to save his job even with the hearing loss, but not like this. He can’t defend himself, much less anyone else. He has taken several different anti-dizziness pills and tried the wrist bands, none of it works. He is not nauseous unless he walks for too long.
Surely people don’t live like this forever. I have googled for days and all his ENT doctors recommend is physical therapy, which he is currently too cranky to take due to massive steroid intake and anger and depression over the possible loss of his career.
Please help us if you can. He is miserable and is packing on the pounds and I’m trying to keep us afloat, but I don’t know how much longer I can row us alone.
Hi Lynn:
If he walks like he is drunk, then he has ataxia–which is brought on by a damaged vestibular (balance) system. If this happened 2 months or more ago, then likely the damage is permanent.
Yes, people do go like this permanently, but there are things they can do to help reduce its effects. So don’t give up hope.
I thought you said he only took 2 doses of steroids. So why is he on massive steroid intake? The steroids haven’t done any good, so he shouldn’t be taking them now. They are just making his body blow up like a balloon and messing him up in other ways.
Not only does he have balance problems and hearing problems, he is also going through the grieving process–denial, anger, bargaining, depression, acceptance. This is normal and good. Obviously he isn’t in the denial stages, but currently you can see him going through the anger and depression stages. Once he works through this he will come to the acceptance stage where he will want to “live” again–and be the best person he can be in spite of any limitations caused by his damaged ears.
Until he reaches the acceptance stage, he won’t be willing to do much, if anything, to help himself.
Hang in there. I know it is tough sledding now, but things will get better if he perseveres and works though his grief and reaches the acceptance stage.
It is here that he will be willing to do what he needs to do to get back on track. And I agree with his ENT that he NEEDS to do physiotherapy regularly–daily–to train his brain to deal with the faulty balance signals it receives. Over time, with practice, his brain will largely learn how to ignore faulty balance signals and he will be able to move around much better. He may have to use a cane or walking stick–especially if the ground is uneven or soft–such as walking on the grass, or sand or hiking in the bush.
I know numbers of people with little or no balance function that have “recovered” much of their balance through hard work. And it takes time.
You and he need to read my article at http://hearinglosshelp.com/blog/regaining-balance-one-mans-story/ . It will give him hope that he can do something similar.
Maybe he needs to consider a different job in the police department–maybe an administrative job, or a teaching job, or a public relations position where he can meet the public and teach them about police/safety/etc issues. Or become an investigator–rather than an active police officer where good balance is critical.
There are lots of options still available to him, but first he needs to work though his grief and then get the physiotherapy he needs to get him back on his feet again.
I wish you both well in the process.
Cordially,
Nei
Thank you very much for answering and giving us some direction. I’m sorry for the delay, but a lot has happened since my inquiry. Something has changed and the doctors are ordering more MRI scans and some type of nerve testing. His hearing hasn’t really returned but he is getting bouts of static and the feeling of fullness in his head comes and goes now. And he has regained 85% of his balance and is no longer dizzy for the most part.
They nor we understand what is going on, but the neurologist is optimistic and so are we. I just wanted to get back on here and thank you for your kindness to us. The few days he used the focal point on the horizon training really gave us hope and then suddenly one morning he could walk again.
I hope your treatment has helped you and I will pray for your complete recovery too.
Again, thank you so much,
Lynn
Hello..Dr Bauman! my wife,age 25years and she suffered with sensorial hearing loss in her left ear 9 days ago(27th may 2017).from then she also hearing some dizziness sounds.we have went to ENTat the 7th day(2nd june 2017) and we started the treatment with steroids that prednisolone 20mg morning after breakfast and 10mg after lunch,10mg after dinner for a week,and my wife is with 5 months pregnant now..Sir please guide me about my wife’s future about her deaf? Your guidelines are very precious to us..
Hi Venkatesh:
You are doing the right thing trying the Prednisone. It seems to help cases of sudden hearing loss. Is the Prednisone helping her? Is her hearing coming back?
I don’t know what else I can do to help you. You see, I don’t have a clue what caused her hearing loss.
Cordially,
Neil
Hi doctor… My wife after taking 40mg of Prednisone for one week,there is a little bit improvement in her sshl effected ear .She saying that now she is able to here phone ring,phone conversation as low level unclarity and disturbed sounds(not able to understand). but now there is a little bit improvement to see with comparing of the sshl effected 1st day..Our doctor has given three weeks course of Prednisone to my wife ..Now we have completed one week course.. How much it possible to recover complete hearing?And is there any do’s,techniques & hearing exercises about to help recover hearing.. Your guidelines are very precious to us..
Hi Venkatesh:
One of my rules of thumb regarding sudden hearing loss is that the greater the loss the less hearing comes back, no matter what treatment you have. So if she had a 40 dB or less hearing loss then there is good chance that most of it would come back. However, if she had say 80 dB hearing loss then the chances of getting much more than 40 dB back would be rather slim.
If she wants to practice constraint sound therapy, that might really help. You can read about it in my article at http://hearinglosshelp.com/blog/constraint-induced-sound-therapy-for-sudden-sensorineural-hearing-loss/.
It also never hurts to take N-acetyl-cysteine (NAC) for a couple of weeks so your body can make glutathione to zap the free radicals that are produced from sudden hearing loss. Taking zinc and magnesium are good too. Read my article at http://hearinglosshelp.com/blog/vitamins-a-c-e-combined-with-magnesium-help-prevent-noise-induced-hearing-loss/ and the last half of the article at http://hearinglosshelp.com/blog/loud-music-and-hearing-loss/ for more on this. (These article were specifically written for noise-induced hearing loss–but I think that a lot of it also applies to sudden sensorineural hearing loss.
Cordially,
Neil
Hi.. Doctor..My wife has completed the Prednisone three weeks course on the instructions of our doctor.. Through the audiometry test 30 percent hearing has recovered. Now my wife with 6th month carrying pregnancy,so our doctor suggested us to stop Prednisone treatment for her health.and he told us to try to recognize the sounds by hearing music through headset with effected ear.
How much probable to recover complete hearing by this way?And also suggest me some about recovering..
Hi Venkatesh:
I agree with your doctor. If she has done a three week course of Prednisone, that’s probably enough. The good news is that she got 30% hearing back. I as told you in a previous reply, that may be all that will come back. It’s been around a month now–and one of my rules of thumb is that generally the hearing you have at the end of a month is what you’ll have going forward.
I suggested that she use constraint sound therapy to help your brain work with her bad ear. Has she been doing this? If not, why not? It is probably her only hope now and even so, the time for this to work is almost past as well. What your doctor is now suggesting is basically a version of this constraint induced sound therapy. It’s worth a try but better I think to do the proper constraint induced sound therapy as outlined in my article.
Don’t expect all her hearing to return. A bit more may come back with this therapy, but I wouldn’t get your hopes up too high.
Cordially,
Neil
Last month I had sudden hearing lose in my left ear and partial hearing loss in my right ear. I went to the doctor and she said it was the start of an ear infection and gave me some antibiotics and told me to take flonase. My hearing did return. To full within a week. Then 1 month later 8 days ago I woke up to total hearing lose in my left ear again. I went to the audiologist and had a hearing test done which reveled 85% hearing loss. I saw the ENT doctor this morning and he put me on a 3 week step down course of prednisone, and is scheduling a MRI. My question is the hearing loss has been 8 days now. What is the Lilly hood of it ever coming back? The doctor just said the nerve went to sleep and who knows if it will ever wake up again that at least if its a tumor he can take it out and my hearing would come back but if its the nerve its just a waiting game.
Hi Kelly:
I have three rules of thumb regarding sudden hearing loss. My 1st rule of thumb is that that greater the hearing loss, the less the chances of it all (or even much) will come back. An 85 dB hearing loss is a considerable loss. You could expect it to come back to maybe 40 dB if it is coming back.
No. 2 rule of thumb is that the sooner hearing starts to return, the better your chances of it mostly coming back. Since you have not seen any changes in 8+ days does not bode well for much coming back.
And the 3rd rule of thumb is that the hearing you are left with at the end of 30 days is probably the hearing you will have in the future.
I’m curious. Did you have a cold or virus active the first time this happened when you took the antibiotics? Also, did you have any cold or virus active in your body this time?
I don’t like your doctors simple analogy–your nerve going to sleep. That is just not true. If the hair cells at the end of the nerves are damaged or the underlying spiral ganglion, then no signals reach the nerve so it can’t conduct them to your brain. It is not sleeping–just waiting for a signal to come through the hair cell at the end.
The real question is whether the damage is temporary or permanent and that I can’t answer at this point. Only time will tell.
Cordially,
Neil
Hi Neil,
Firstly thank you so much for the information that you share on this site, it has been an incredibly useful source to review. I know you touched briefly on a response to a pregnant woman who had experience hearing loss and wondered whether you might be able to offer an opinion on my situation. I am pregnant with twins and at about the 26 week mark I had been suffering from a cold and then it turned into bronchitis, for which I was put on a course of AMOXYCILLIN, followed by AUGMENTIN. On the last day of this single course of AMOXYCILLIN, I woke up with significant (if not full) hearing loss and tinnitus on my right. Very frustratingly, there was no concern raised at my hearing loss (or I would have acted earlier) and it was put down to ‘possibly’ sinuses. 3.5 weeks after my hearing loss (and having completed the AUGMENTIN) I went back to a GP and asked for a referral to a ENT who was on the phone to me within 45 mins arranging a hearing test and the folvogin day gave me a full audiology test (profound hearing loss) and gave me a steroid injection directly into my ear. I have since had an MRI (clear) and am waiting on my blood test results. My question is, have you found any evidence or research of the potential impact of a pregnancy (twins in my case) causing/ triggering hearing loss as a stress response? Is there any hope that post pregnancy I may find some further changes or will the length of time of my hearing loss and (profound) extent of hearing loss – almost 100% be too great an impact? If you are able to direct me to any further research or other treatment options I should be considering, I’d be most appreciative, as the feedback I have been given thus far is that it is idiopathic and no-one can tell me why it’s happened and therefore provide me with any further solution. They have noted in their opinion my chance of recovery is remote, which has scared the daylight out of me, so I’d like to ensure I am exhausting every avenue to find anything that is time critical that I should be doing prior to having these twins.
Thanks again,
Cheers
Gen
Hi Gen:
As I see it, there are three possibilities regarding your hearing loss.
First is otosclerosis, however, I do not think this is likely in your case. Besides, the doctors should have picked up on it right away if you have it.
Second, a viral attack on your inner ear. To me this is quite likely. Viruses can attack one ear or both ears and cause any degree of hearing loss right up to profound. Often it happens almost overnight–you don’t have much warning at all.
One thing you didn’t mention is whether you had an balance problems at the same time–such as dizziness, vertigo or a sense of being off-balance.
The third thing is the Amoxicillin. Amoxicillin can cause hearing loss too.
In your case, I think it was the virus and maybe with some help from the Amoxicillin.
I don’t think your pregnancy had anything to do with it.
If it was otosclerosis, then your pregnancy would have been a big factor and will normally cause further hearing loss with each succeeding pregnancy. But as I said before, I really doubt you have otosclerosis.
In the future, I’d be very cautious about taking Amoxicillin (Augmentin) in case it was the culprit. But to me the most likely case was a viral attack on your ears from the cold virus you had just before your hearing loss occurred.
Unfortunately, it is highly unlikely you’ll get any hearing back now. Your best bet is to get a hearing aid if it will help you–or perhaps a CROS aid to pipe the sound from your deaf side to your hearing side if that helps you understand speech better when people talk to you from your deaf side.
Cordially,
Neil
Thanks for your feedback Neil.
In answer to your question, yes, I did experience dizziness and a sense of being off balance however given I was also very low in iron at the time which made me feel faint, sometimes it was hard to decipher which was which. I have read back through some messages I sent however and I definitely had dizziness with the hearing loss.
Wow, I had no idea a viral attack could result in something so significantly irreversible. In terms of confirming with my ENT doctor that it is not otosclerosis, are there any specific forms of testing I should expect him to do to establish this?
It has been suggested to me that they may give me another steroid injection into my ear this Friday, would you consider this pointless or worth trying in the case that this is the result of a virus attack? (which I agree seems the most likely scenario given I was sick for about 2.5 months with chest and sinus infections, and the antibiotics and then hearing loss came at the end of this.)
Thanks again for your wonderfully informative feedback, I feel as though I have gotten more insight and information from your forums that I have from the multiple medical practitioners I have spoken to.
Thanks, Gen
Hi Gen:
Often viral attacks affect both your hearing and your balance. To me the best guess it that it was viral. But I sure wouldn’t be surprised if the antibiotics you were given also played a part. There’s no way to separate one from the other as far as your side effects go.
If you have otosclerosis, you should have an air-bone gap showing on your audiogram–assuming that you have enough hearing to get reliable readings using both air conduction and bone conduction testing.
At this late date, I’m not optimistic that steroid injections will help. If it were me, I wouldn’t bother, but you have to make up your own mind.
Cordially,
Neil
I was suffering from strange hearing issues in my right ear in early July. I asked to be referred to an ENT by my PCP when I saw her but she asked me to wait a few weeks to see how it improves. Unfortunately it seemed to get worse by the time I finally got an ENT referral. At my audiometry testing I was at 50dB in the 250-500 range and 30dB in the 1k range. Everything else is mild to normal.
Unfortunately I’m only 31 and it’s now been six weeks since I started noticing the issue. I started on Prednisone 5 days ago but I haven’t noticed any improvement and I only have a few days of steroid treatment left. I don’t currently have vertigo, so I’m not sure if Ménière Disease is likely but I haven’t received any specific diagnosis.
Based upon your responses above, it sounds like I should probably get used to this being the new normal. I had an MRI and fortunately they didn’t find any growths that could be causing the issue. However, I’m trying to get into the local university for a second opinion, although I’m not terribly hopeful at this point.
1. Is there any formal evidence of something treatable that could cause growing, long-term low-range unilateral hearing loss?
2. What questions should I be asking when/if I need to be fit for a hearing aid? I’m desperate to find something that will make music sound natural seeing as I won’t need a device in my left ear.
3. What kind of general advice might you have for someone my age dealing with reverse slope hearing loss of this type?
I really appreciate your contributions on this site! Thanks for everything!
Hi Justin:
Tell me more about what happened to your ears back in July around the time this all started. That’s always the best place to start. What was different that may have cause your ear problems? Exposing your ears to loud sounds? Taking any drugs or medications or vaccinations? Having any active virus (cold, flu, herpes, etc) in your body at that time? Undue stress? Etc.
To learn much more about reverse-slope hearing losses read my comprehensive article on the subject at http://hearinglosshelp.com/blog/the-bizarre-world-of-extreme-reverse-slope-hearing-loss/ .
Now to answer your questions.
1. It’s possible, but I can’t think of anything at the moment. A good otologist should know.
2. Your hearing loss is probably not conducive to wearing hearing aids at this point since you have normal hearing in the mid and high frequencies. You may find that wearing a hearing aid just makes things worse as hearing aids typically do not amplify the very low frequencies.
I don’t think you can make music sound natural in your bad ear considering your loss is in the very low frequencies. I’d suggest you listen more with your good ear as it should hear music naturally.
3. Read my article mentioned above and glean what you can from that. You can go to an audiologist and see whether a hearing aid may help if it is programmed to your hearing loss. It could be worth a try–although I’m not very optimistic that you’ll be happy with it–but you never know.
Cordially,
Neil
I thought that I had swimmer’s ear from the bathtub. That’s all it felt like at first but it continued to progress. It started with a subtle, full feeling like it had to pop. My cats’ meows were especially high-pitched and somewhat robotic sounding in that ear.
After a few days I reached out to my PCP to get an ENT referral, but she instead asked to see me the next week. They checked it out and said it looked fine and to wait a few weeks to see if it improved.
I asked for an ENT again but they said it was probably going to go away. They suggested Sudafed or Afrin. Neither worked and Afrin seemed to make it worse.
After a couple weeks I reached back out to my PCP to demand the referral. The low frequency tones were really starting to disappear at the time. The ENT took another week to get me in.
He said the loss was permanent and to come back in 2 months for a hearing aid fitting. It wasn’t until I came across your site that I realized the type of loss I had was unique.
He did put me on Prednisone, of which I’m nearly done. Unfortunately, it doesn’t seem to have helped and it may have even progressed in that time.
My MRI was fortunately clear of any strange growths, but I have an appointment at the University of Washington on Tuesday to hopefully get a more comprehensive analysis and diagnosis.
My reverse slope in the right ear is very significant (moderate-severe) under 750Hz. There does seem to be a minor reverse slope in my other ear as well though, which I’m not sure is concerning or not. That ear is currently in the mild to normal range.
Hi Justin:
I’m curious. What have the doctors said about the cause of your reverse-slope hearing loss when they did the more comprehensive testing?
Cordially,
Neil
Hi neil sir
I am from india. One day in may 2017 i have sudden loss my both ear hearing but after some time my right ear hearing become normal. I visited more then 3 doctors but nothing change with my left ear. I have a continious sound of weeping in my left ear. Now i am worry about my right ear. Kindly suggest me some doctor in india. I have lack of money for treatment so kindly suggest some medicine which can i use for treatment.
Hi Ramanand:
Too much time has passed for anything I know of to help bring back your hearing in your left ear. I think you’ll find it is permanent. The sound you hear in that ear is one of the many tinnitus sounds. Tinnitus almost always accompanies hearing loss such as you’ve had.
Rather than trying to find a “cure”, you need to put your energy into learning how to successfully live with single-sided deafness.
Cordially,
Neil
I suddenly had about an 80% loss in 1 ear at about 6 PM. – sounded like everyone whispering. I planned to go to urgent care first thing in the morning. No illness, no loud noise.
However, when I woke up about 5 AM, full hearing had returned. What is going on?
Hi John:
One cause could be a piece of wax that blocked your ear canal and fell away during the night. I’d check that your ear canals are clear of wax.
A doctor or audiologist could tell you whether you have wax in your ears.
That’s the most obvious cause that comes to mind. There could be other causes, but I’d check this one out first.
Cordially,
Neil
Dr. Bauman,
Thank you so much for the insightful article. I have been dealing with SSHL off and on again for the past year. The first recovered after prescribed steroids from my ENT. The second time, the hearing recovered within just a few days. I’m now experiencing my 3rd case and I’m quite troubled by it. Where as before, I woke up with sudden loss of hearing, this time was gradual and accompanied by pressure (as if flying in a plane). I’m concerned that there is more to this, such as onset of Ménière
Hi Lauren:
How far apart are these episodes of sudden hearing loss? Are we talking about months or years or what?
Why would you think that your episodes are more related to Ménière’s disease as opposed to for example, autoimmune inner ear disease or stress episodes or something else?
If it were full-blown Ménière’s disease, you have two of the four symptoms, namely fluctuating hearing loss and a feeling of fullness in your ear. What you are missing is tinnitus and vertigo.
you can have a subset of Ménière’s their art. There are two subsets. The first one is called cochlear hydrops where the symptoms are tinnitus and fluctuating hearing loss. The second subset is called vestibular hydrops where the symptoms are a feeling of fullness in your ear and vertigo. If you want to learn more about Ménière’s and they real underlying cause. Read my article at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ and see whether this applies to you. Then you can seek appropriate treatment.
Cordially,
Neil
I’m a week in on SSHL on prednisone by 4th day and diuretics. I’m 49 and have struggled with ear problems since I was about 13 I have had four surgeries but the last was over 25 years ago. I struggle with chronic ear infections due to large canal revised radical mastoidectomy. I had moderate hearing loss about 40bd in left ear. Back in August I had a huge boil in my ear canal which was swollen and painful it eventually healed and then couple days later I had a fluid like cycst just inside my ear canal red and yellow like color I was able to take a picture of it. Fast forward three months I wake up to SSHL 90-95bd basically high frequency loss moderate low frequency, nodding tinnitus and ear fullness. The ear fullness is what bugs me the most. Does that improve? I’m not optimistic giving my history. Just don’t understand what caused it to happen all the sudden viral, vestibular or ???? I’m going to go for MRI soon to check as I have had a tumor in my spinal cord couple years ago.
Just real curious about the ear fullness driving me crazy.
Hi Deeanna:
If the ear fullness is the result of a clogged Eustachian tube, then the ear fullness should disappear when any gunk in your middle ear and Eustachian tube drain away.
If your ear fullness is a psychological feeling rather than a physical reality, it is the result of your sudden hearing loss. Your brain is thinking, “The ear must be blocked, because if it’s not, surely I would hear something, wouldn’t I?” So you get this psychological feeling of your ear feeling full or blocked.
I would expect that this blocked feeling would slowly fade away as your brain gets used to the fact that it doesn’t hear anything from that year. It may take weeks or months for this to happen.
Cordially,
Neil
Hi Neil,
This blog on SSHL has been helpful as I woke up this morning with SHL in my right ear. Although I had no noticeable cold I did have the sniffles the other day and a little bit of itchy throat. I went to the doctor today and they confirmed my right ear has loss around 2000hz. The ringing comes and goes. I had the television on earlier and thought things were getting better, and then a mobile phone rang in the show and I only heard it out of my left ear.
I’ve been prescribed prednisone and after hemming and hawing about it I will fill it in the morning and take my first dose. But something keeps bothering me and I wanted to ask your opinion.
I have suffered from Psoriasis since my teens (now 41). I’ve taken biologics for some time now and am about a year into using Cosentyx after years of Humira. When the Humira started to decline I noticed strange periods of short term “odd” issues. A 2-3 week flare up of hives, a period where my toes and knucle joints hurt on and off immensely, a brief period of time with strange breathing issues, random intense back pain that would be dismissed as a muscle spasm by the ER, etc. Every time I’d see the appropriate doctor for these matters they’d be dismissed. I started to think they were potential side effects of my Psoriasis becoming Rheumatoid Arthritis symptoms.
When I began taking Cosentyx these things stopped happening, leading me to believe that I had found a new biological that was addressing the auto immune system issues that may have been triggering those incidents.
I put off my monthly dose of Cosentyx because I took the flu shot and felt those sniffles coming on. Now hours after my doctor appointment I wonder if my SHL could be a new auto immune system?
I’m also wondering if I am taking the prednisone as I intend to start first thing in the morning should I hold off on the Cosentyx (it weakens the immune system by design) or take it promptly in case the SNL was triggered as a side effect of my Psoriasis and possible (but undiagnosed) RA?
Hi David:
My guess is that the flu shot caused your hearing loss. This happens to numbers of people. To me this is the most obvious and most likely cause.
Cordially,
Neil
My Mother Loss hearing suddenly. Before the loss, she was having cold, cough. She is having blood sugar (300 after food ) & high blood pressure.
Kindly suggest, what could be the reason & is it is curable ?
Hi Pramod:
It sounds like the cold virus got into your mom’s inner ears and caused the hearing loss. This happens to many people. Unfortunately, once the damage is done, there’s not much you can do. The hearing loss will likely be permanent. Typically, if the hearing doesn’t come back after 30 days or so, it is time to consider getting her hearing aids so she can hear again.
Cordially,
Neil
Kids playing with vehicle windows caused immediate ear pain to both ears. Hours later noticed low echo/reverberation listening to TV. 1 week later and no improvement. Its like having boom box attached to head. No cold/flu or signs of infection. Waiting for ENT to contact me and set up app’t. Is it safe to wait for 2+ weeks to be evaluated? As a musician very concerned about potential long-term hearing impact.
Hi Debra:
I don’t understand this statement, “Kids playing with vehicle windows caused immediate ear pain to both ears.” Exactly what happened. I’m not seeing the connection from this terse statement. You need to explain this in more detail.
Cordially,
Neil
Hi Neil –
To begin, I reside in Shenzhen, China so I am a touch skeptical of the care I am receiving at a Chinese Public Hospital.
About a month ago, I used a neti pot and blew my nose too hard after. It felt like I blew water into my inner/middle ear. (Not the first time.) In the middle of the night I got up to pee and had a very bad vertigo spell. I thought it was weird, but just figured it had to do with the neti pot incident. I did not notice any hearing loss, just the discomfort of the fluid in the ear. A week passed and the ear seemed pretty much back to normal. I work in public school and was feeling paranoid about getting a cold so I did another neti pot and although I tried to more aware of blowing softly, the exact same thing seemed to happen. I do not recall that I had another case of vertigo quite like the first time. I noticed no hearing loss.
Again, time passed, after another week or so I started to notice more pressure (like on a plane) and kept trying to pop my ears. I also noticed the ringing. No vertigo. Last week the pressure seemed to keep building. I thought maybe I had wax build up, I started putting olive oil in my ear. Then I began to notice an itching sensation along with the pressure. I should have known better, but I used a bobby pin to try to scoop out some wax. I was careful not to go to deep, but after my ear felt “funny” – no pain exactly – not really even discomfort – just more like something had been disturbed. I looked up my symptoms and thought I might have some sort of mild ear infection so I finally made an appointment to see a doc.
I went this past Wednesday and was floored to be diagnosed with Sudden Hearing Loss as I hadn’t noticed any loss in hearing! The test says R ear -41 dP (I think that was at 4000 kHz) the L ear is normal (these were the doc’s words). Other numbers on the hearing test about the R ear 1.77 mi and 0.45 mi. Whatever is in front of those numbers is written in Chinese so I don’t know what it says.
She prescribed 5 medications including a 4 day course of steroid and wants me to return to be retested tomorrow (day four after first being seen). I still have the feeling of pressure in the ear (sometimes yes sometimes no) and tinnitus. I’ve read through all of the questions and comments and understand the the psychological aspects of these symptoms.
I am wondering about your opinion on my situation – cause and potential recovery. When I return to the hospital tomorrow are there any tests or information I should ask for/about?
Additionally, I have Herpes, but was not experiencing an outbreak when I had the first bout of vertigo after the Neti pot and my right ear drum ruptured about 7 years ago.
I really appreciate you taking the time to read and respond as I really do feel I’m in no man’s land here given the difficulty with commuication.
On last thing, as a 25 year yoga practitioner I am interested in in natural things. Links to articles around treatment are appreciated.
Best and many thanks,
Carla B.
Hi Carla:
The only way you can get the water of the neti pot into your middle ear (not inner ear) is via the Eustachian tubes in the back of your throat.
You probably already had the cold virus that caused your hearing loss and vertigo unless your neti pot was already infected and your spread the virus into your middle ear that way. You really have to be careful about the sterility of your neti pot or they can do more damage than good.
It’s possible that the herpes virus caused the problem, but since it wasn’t active, and you probably had the beginnings of a cold so were using the neti pot, I’d put it down to a cold virus, unless you have more information.
As far as natural remedies, etc., the best thing you can do of course is keep your immune system robust so it can fight off invading “bugs”. One thing that just shoots down your immune system is getting too much sugar. If a virus is around at just that time, you get the cold or whatever.
Cordially,
Neil
Within the past couple of days, I have experienced one of the worst (if not the worst) headache I have every had in my life. The attack came suddenly, left eye pain and a piercing, ice-pick pain on the top left side of my head. It was accompanied by nausea, dry heaving, and weakness. In addition, I experienced sudden (but not complete) hearing loss. I also stumbled when trying to walk, almost like a drunk person and injured my hand in an attempt to break my fall. Now two days later, the hearing loss is getting worse and affects the left ear more than the right. I feel incredibly drowsy with that “jerky” sensation of falling asleep and waking yourself up, nausea, and a general sense of just not feeling well. The only way I can describe it at this point is if my brain was an egg, that headache scrambled it BAD and now I have had significant hearing loss as a result. I was told it could be a possible inner ear infections, but this is unlike any sensation I have ever had. Left side pupil appears to be dilated as well. I am a 34 year old female with no significant medical history save one ulcer and kidney stones about 7-8 years ago, no surgeries or malignancies, no hypertension, no history of migraines save for the other significant headache event (loss of consciousness with that headache and doctor ruled it as a migraine due to “spontaneous recovery” –
sent me home with migraine Rx, no tests or imagining done at this time). Any advice would be greatly appreciated. Thank you!
Hi Tamara:
I’m not a medical doctor, but it seems to me that you suffered either a stroke or other vascular event (burst aneurysm for example) that stopped blood flow to parts of your brain. If I was in your shoes, I’d get a second opinion NOW. I’m thinking that the hearing loss is secondary to the interrupted blood flow.
Cordially,
Neil
Hello. I would like some opinion. I had a sudden hearing loss on the 13 Sept 2011… It’s been long time. I went to see Dr. They told me cause is unknown. I got prescribed steroid. Didn’t work….. I had a terrible tinnitus I. My right hear… The noise was so bad. I thought about killing myself a few time… Very hard time in my life.. I got hearing aids maybe 6 month later.. Tinnitus was terrible but life goes on.. It’s been 7 years. I got use too it.. I need hearing aids or I don’t understand wht pp say.. Recently. Maybe a year ago I start to see some improvement… And recently.. The last 6 month.. I m like understanding more ND more. Without my aids. Like today I went swim on the beach. I heard the water and the wind.. Hearing is not perfect and wht it use to be. But it’s getting better… I do t know of it’s me or if I’m getting crazy but I see some improvement… My hand to cut. From my experience.. Hearing loss.. Well mine. It’s related to intense stress. Compressing the brain or something.. I have injured myself at work. And I’m on compo at home. It’s been 6 month.. Belive it or not… I feel less stress and my hearing is improving.. Still have the tinnitus. But it’s not insane like before. I take a lot of vitamin. Ginkgo Bilbao. Raisin grapes. Anti oxident… I read online it can be helpful…. Now I do t know if it’s less stress or vitamin. Or if I’m going nuts but I feel better. I have a hope that. One day I will hear again like before the accident…. I cannot understand how come scientists ND Dr. Didn’t find out how to fix that yet… It’s insane…..do I have a chance to be like before one day??? Oops didn’t mention its my right hear.. My left hear been bad since iam 2year old because of a meningitis. Right hear was fine… Until the accident.
Hi Medhi:
The easy way to know for certain whether your hearing is coming back is to go to an audiologist and have your hearing tested. Then compare the results to your previous audiogram.
Depending on the cause of your hearing loss, it is possible (not common, but possible) for hearing to come back years later. In your case, you are less stressed and anxious, and this lets more blood flow into your inner ears–and that could account for some returning hearing. Also, some of the supplements you are taking such as ginkgo can increase blood flow.
I doubt that you’ll get much hearing back because I think your hearing loss was mostly caused by hair cells dying–so that hearing will not come back. But you may also have some hair cells that were just “sick” and the increased blood flow to your inner ear has made them well again so the hearing they control has come back.
That’s how I see your situation so don’t be disappointed if not much more hearing returns. But if it does for whatever reason, feel free to jump for joy!
Cordially,
Neil
Have sshl for 3 days, now on prednisone. Highly concerned about tumor, blood clot. This happened just after a flight home, but have had low tinnitus for over 6 months in that ear. Can I continue to fly with this issue? By the way, thanks, this blog / info seems to be the best info found.
Hi Ryan:
Were your sinuses or ear congested before the flight? Or did you have a cold before/during the flight? That’s causes hearing loss for some people. If this is the case and you have to fly, many people find that taking a decongestant an hour or two before takeoff and an hour or so before landing can overcome this problem.
Why do you think you have a tumor or blood clot? I don’t see a tumor as the culprit after a flight, but a blood clot could be a possibiility, although I don’t think it very likely if this was your only symptom.
Cordially,
Neil
Hello Neil,
I have had concerns for my right ear for years. Very often I would have a feeling like I have water trapped in it and feel some presure in it.
At the end of December 2017 I had a flu. Within a week after recovery I started noticing more and more frequent episodes of presure in my right ear and loss of balance. I had a friend “doctor” recomend that I take Amoxicillin 1000 Mg 2 times a day ! ( I am 225 pounds) for 10 days in case I have bacterial infection of the inner ear. 5 days after I have completed the course of antibiotic, following a few nights of drinking with friends, on February 4th, 2018 I have experienced a scary episode of losing balance, tinituis and some vertigo and nausea. Right away there was a severe hearing loss in my right ear! Since that day, I have not be able to talk on the phone with that ear, loud sounds are extra lound and sharp. By now, 13 days later, the audiogram from UHEAR app is linear right sloping and shows normal hearing at .5K, moderate loss at 1K, moderately severe at 2K, 4K, and at 8K. I am taking prednisone for the second day.
The ER doctor who saw me after attack on the 4th of February said I had Menieres. The doctor who saw me two days ago and who gave me prednisone is diagnosing me with SSHL for now and wants to observe. I have unstable walking now occasionally, perioudic presure in my ear, tinituis.
Neil, If I had a ruprure of endolymphatic membrane on February 4th, can I expect hearing to return to near normal, especially high pitch sounds at some point? How long do you think it may take? In your opinion what has caused SSHL in my case and what is your prognosis?
Thank you, very much!
Evgeni
Hi Evgeni:
You may have several things going on in your ear. First, you have a long-standing problem with a feeling of fullness in your ear. That may be a problem with the top to vertebrae in your neck being out of proper alignment and “pinching” you trigeminal nerve which controls your Eustachian tube among other things.
Second, you had the flu and the flu virus could have attacked your right ear and caused hearing loss, tinnitus, and various balance problems, not to mention making some sounds too loud and sound sharp (hyperacusis).
Third, taking all that Amoxicillin could have also caused all the above symptoms. It’s done that in many people.
I doubt that you have Meniere’s–your hearing loss isn’t consistent with typical Meniere’s.
What makes you think you had an endolymphatic membrane rupture?
I think the most likely scenario is the flu virus causing some damage, then even more damage caused by the Amoxicillin.
Personally, I doubt your hearing will return to normal–especially in the higher frequencies if I am correct that either the flu virus or the Amoxicillin was the basic cause of your ear problems. Your balance problems may slowly disappear as your brain learns to ignore faulty balance signals from damaged balance organs. You can probably hasten this by a program of certain exercises to force your brain to improve your balance.
Cordially,
Neil
Hello Neil,
I suffered SSHL in left ear 23 Feb 2018. I had reverse slope low frequency losses and terrible hyperacusis. I eventually got to an ENT 8 days later and started on oral Prednisolone after audiometry. I commenced HBOT as well. Two weeks later minimal change so we started on intratympanic injections of Dexamethasone every 3 days x 4 times.
An audiometry was conducted again and disturbingly I had suffered further hearing loss. The day preceding this I had done some moderate exercising (not sure if that had an effect?).
I was put back on Prednisolone for a few days until I saw the neuro otologist. She decided against the 5th injection and placed me on Nicergoline 30mg (for hyperacusis) . All along since I first saw ENT I have been on Betahistine 24mg x 3 t.d. as well. She also put me on 3600mg Acetyl Cysteine per day.
I have been on a raft of supplements – from reading your posts and other published research.
On 6 April 2018 I was in a minivan for 8 hours in a very bumpy ride. Later that day I carried out an audiometry test (using an Android app that I use as a guide only for comparisons). To my disbelief nearly all of my hearing had recovered. I could hear all frequencies well – bass sounds came back in my right ear. No hyperacusis. I was amazed.
Over next few days I had some deterioration again but not much with 500Hz onwards being on par with left ear.
Two days ago my tinnitus started getting loud and bothersome and some irritation to noises making me have to turn off the TV and any other sounds. I had gone for a run and jog that day for about 2.5km.
Yesterday I had very sensitive tinnitus that hurt from many sounds (was near a waterfall next to a pool and it hurt). Higher pitched sounds started to hurt. And conversations harder to understand.
Yesterday afternoon I decided to exercise and went for a good jog and walk for about 2.5km.
Last night before sleep (prescribed Clonazepam 0.5mg before bed and Lorazepam during day PRN which I have been taking about one a day since hearing has been getting worse). The tinnitus had faded to a fairly comfortable level.
I woke this morning to realise I had suffered a severe hearing loss. I used the Android audiograph app again and to my horror frequencies had dropped everywhere especially low frequencies. I felt part deaf now. Throughout the day I have felt a fullness in the ear and worsening hearing. An evening test show severe/profound hearing loss in in low frequencies and moderate losses in higher frequencies.
So in a period of 7 weeks since my SSHL I had recovered to full hearing again and 6 days later it has worsened more than the initial hearing loss on 23 Feb 2018.
ENT suspects Cochlear Meniere’s as I do not have vertigo, did not have fullness until today (but that has now stopped), but I have suffered tinnitus the whole time with sometimes it extremely loud and other times mild.
He tested me for BPPV today as I mentioned some woozy feeling when I was sitting and looked straight up above me or looked straight down and lay down at times. But negative.
I am absolutely petrified as to what is going on. I have high cholesterol and the whole idea of exercise is to reduce that, but whether it’s coincidence or not, the days after I have exercised I have suffered hearing loss episodes again. So am paranoid to exercise now.
A referral to a cardiologist after blood tests revealed high cholesterol – he put me on Atorvastatin. I took it for 2 days but after reading it is linked to hearing loss I stopped (4 days before I had my recent SSHL attack).
I would love some suggestions as to any clues what is going on inside my head. I am suffering psychologically so much from this. I have become a hermit and bedridden mostly, hating life.
Hi Peter:
I pretty much understand your situation, but you have left out a few very important things that would help me be certain what you problem is. If it is what I am thinking it is, the good news is that it is very easy to fix–even though your medical doctors don’t have a clue.
I agree with your doctor that you seem to have a version of Meniere’s disease–although it is not full-blown at the moment. You have 3½ of the four symptoms, fluctuating hearing loss, tinnitus, feeling of fullness in your ear and vertigo. You don’t have the vertigo (yet) but you do have some imbalance issues so I gave it a ½ point.
What I need to know is the condition of your neck. Have you ever been in a vehicle accident and had whiplash, or otherwise had head/neck trauma? Is your neck/shoulders “tight”. Do you have TMJ?
If the above are positive, then I’m not surprised that you now seem to have Meniere’s. You see, Meniere’s is basically caused by your C1 and C2 vertebrae–the top 2 vertebrae in your neck–being out of proper alignment.
The cure is simple. Go to an upper cervical spine chiropractor and have him get you in proper alignment and your Meniere’s goes away as if by magic.
I wrote a comprehensive paper on the subject that you can read at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/
Everyone that has followed the advice I give in this paper has been able to wave goodbye to their Meniere’s. I hope you can do the same.
You can find upper cervical spine chiropractors in Australia by going to http://www.upcspine.com/prac2.asp?rid=1 and clicking on your state/territory and then choose one close (or relatively close) to you.
It seems that when you jog or bounce you either loosen up or tighten up your neck. The former shows improvement in your hearing/tinnitus etc, while the latter makes it worse. And worry makes it worse as it causes you to “tighten up” also.
Read my article first, then decide what you want to do.
I wish you well.
Cordially,
Neil
Thanks Neil, interesting you mention the neck. I had a bout of serious depression (with PTSD) and used a rope around my neck that I think may have caused or aggravated a cervical vertebrae years ago. Xray in 2012 just showed a slight tilt but doctors dismissed it.
The report read:
“Findings: The upper cervical spine is slightly tilted to the right. There is a scoliosis at the mid-cervical
spine convex to the right, apex at C3 level. Height of the cervical vertebral bodies is well maintained.
Spondylotic changes are present at the C5/6 level with disc space narrowing and small endplate
spondylophyte formation. The atlanto-odontoid space is normal. The oblique views show no
significant narrowing of the exit foramina. No cervical ribs.”
Gym workouts sometimes aggravated it and I would often physically pop something in and out at the joint area that I think is the tilted vertebrae to help alleviate pain.
I have a jaw that I can click a bit but I don’t think I have TMJ? I have no pain from it.
I don’t feel like my neck and shoulders are tight. I have been told I do have a bit of a tilted leaning forward posture with my neck as well.
I have read your article (will need to read it several times as a lot of info thanks)
I will find a chiropractor and see if it helps though. In Thailand right now if no good here will be back in Australia in about 1.5 months. Thanks Neil. Appreciate it. Will update results.
Hello Dr. Neil,
About 7 months ago I suffered from SSHL. I visited 3 doctors at the time but unfortunately due to them delaying referring me to a specialist it wasn’t caught in time to treat it. My hearing loss at that time was moderate with a few high frequencies being severe. I also had tinnitus but was able to adapt to it after a few months. 4 months after my initial occurrence of SSHL it happened again and my hearing got slightly worse. This time the specialist treated me within a week and prescribed oral prednisone as well as three intratympanic steroid injections. Over the next two months my hearing improved. Now just yesterday I suffered from my third occurrence of SSHL. I was just laying in bed and rolled over on my left ear and it almost sounded like my ear drum made the noise of bouncing and my hearing got immediately worse with much louder tinnitus. So far I have had and MRI and blood work, neither of which has determined a cause. I am also pregnant this time so I don’t believe it is safe to be treated with oral prednisone. Do you know if the injections would be safe? Also, do you know why this would keep happening? Is there anyway to prevent it?
I should also mention that the last two times have happened a few days after commercial air travel. I did not feel any discomfort or issues during the flights. And have flown a few times in between these two times with no issues. Also, this time I having been feeling very dizzy for the last two days.
Hi Nicole:
My first reaction to reading your story is that you are in the early stages of Meniere’s disease–where you get periodic attacks of hearing loss, tinnitus, and vertigo and your ear feels “full”. You don’t have the full-blown version, but there are a couple of variations–one called cochlear hydrops which has the hearing loss and tinnitus and feeling of fullness, but not the vertigo.
This may seem like an unrelated question but it is very pertinent to the issue. Were you ever in an auto accident and had any degree of whiplash, or did you ever have head trauma of some kind. If so, you need to read my comprehensive article at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ and see if you identify with any of this. If so, the solution is given in the latter parts of the article.
This seems the most likely scenario to me based on what you have said.
Cordially,
Neil
I have two questions. I suffered SSHL in my left ear about 18 months ago. I have mostly adjusted. First, I found that being on a salt restricted diet helped me feel much better, although I don’t have any diagnosis of Meniere’s. Does this make sense? Second, I used to be a scuba diver. I’m 64 years old. Is there any reason I should not scuba dive? I am an active participant of a Facebook support group: Sudden Hearing Loss Support Group. Our biggest complaint is that it is tough to find answers to our questions. Thank you for this blog.
Hi Donna:
How do you feel better on the salt-restricted diet? Better generally, or better in relation to your ears? Personally, I don’t see that a low salt diet has anything to do with SSNHL so there can be another factor at play here.
Again, assuming that your SSNHL was not related to pressure problems, I don’t see any reason not to scuba dive. However, if your restricted salt reduces inner ear pressure and that makes you feel better, then the increasing pressure you’d feel scuba diving would be bad and I wouldn’t recommend it.
Support groups are great (I’m a member of a number of them), but too often it is like the blind leading the blind. They work better if there is a person or people that are experts in the subject and can give direction as needed. Then too, once people find the answers they need, they leave and get on with their lives. As a result, it’s those who haven’t been effectively helped that stick around and they obviously don’t know the answers so you can get a warped view of what works and what doesn’t.
If you think you may have undiagnosed Meniere’s disease, or one of the versions of it–cochlear hydrops or vestibular hydrops, you would do well to read my comprehensive article on the subject at
http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ . It will help you decide whether you may have the precursor to Meniere’s disease and need to take appropriate action. Then you’d be free to resume a regular diet and go scuba diving again.
Cordially,
Neil
I had an SSHL overnight while on a cruise in April 2017…. I’m a lifelong musician/singer and my hearing loss has impacted severly on my enjoyment and playing music… I have had numerous hearing and neurological specialist referrals, hearing tests , and the prognosis is that hearing aids will njot help, the auditory nerve has died.. I have lost my upper hearing range which is what most of us rely on day to day. Along with the SSHL, there is severe tinnitus – sounds like a waterfall over ice, a blocked ear, nerve sensitivity down that side of my face, and a ‘pop’ in the ear whenever I use any facial muscle.. I have told the hearing loss is permanent, and a hearing aid will only amplify what hearing I have – which is lower frequencies, amplifying which only genrates excessive bass and ‘rumble’ volume,.. What I do not understand is how hearing aids can benefit some with heraing loss but not me… ??? Contrary to this and other articles on SSHL my specialist told me that specific medication needed to be administered within hours of the hearing loss, not up to 10 days, to stand any chance of success. On board the ship, I was given antibiotics for a perceived ear ‘infection, so likely cause was probably the most common – a virus of the inner ear… Whatever, the loss is permanent and one has to live with it. But it could be worse, I ahve one good ear and can still tell whether or not I’m playing or singinbg in tune… !!!!! timradaord ship
Hi Rhod:
Almost all people with sudden hearing loss (and hearing losses in general) do NOT have dead nerves. That is a misconception. What does happen is that the nerve is perfectly healthy, but some of the nerve endings (the hair cells in your inner ear) have died. That’s a totally different things than saying your nerve has died.
Secondly, hearing aids should help you. Hearing aids are MADE for people with dead hair cells. So I think your doctors are totally ignorant on the subject. Hearing aids help me yet I am functionally deaf without them. It is the VERY rare person for whom hearing aids cannot help–and for those people, cochlear implants very often do help immensely.
Almost always, tinnitus accompanies hearing loss–so that is to be expected. However, you can deal with it so it no longer bothers you.
I’d have to see your audiogram before I agree that hearing aids cannot help you. It is true that if you have absolutely no hearing in the higher frequencies, then you’ll only hear louder bass sounds. However, there are special hearing aids that can transpose the high frequency sounds down to the lower frequencies when you still have hearing so you can hear these sounds–but at a lower pitch. This works very well for some people. I don’t think you’d like it as a musician–because it would always sound “off”.
Normally, you’d take steroids such as Prednisone or Prednisolone as soon after the hearing loss occurred as possible–but they can still work up to two weeks or more later–but often with less success. However, steroids don’t always work. Sometimes hearing comes back without any treatment, sometimes it comes back with steroid treatment and other times in never comes back in spite of any treatment. Thus there was no guarantee any drugs would have helped.
The good news is that you still have one good ear and that’s a great blessing. For music, you will probably find that you do better without a hearing aid so you only hear sounds at proper pitch.
Cordially,
Neil
I lost my hearing overnight, and immediately saw and ENT, who prescribed oral steroids and 3 injections. My left ear had severe hearing loss, after 10days my hearing was restored to moderate hearing loss. The loss as of the moment is classified as IDIOPATHIC. My advise is get treated ASAP for any chance of recovery. I will still need a hearing aid to hear to my full potential, but that just fine with me.
I have fully recovered from SSHL since I am only 35 years old and have only a little hearing loss. But I am wondering is SSHL related to using earphones? And can I use earphones in the future?
Hi Dylan:
Typically, SSHL is not caused by wearing earphones–unless you have the volume ridiculously loud–and even then, it normally takes months or years to produce hearing loss.
You can always use earphones without damaging your ears IF you keep the volume of whatever you are listening to, to about the same level as you hear people talking. Normal speech doesn’t damage ears. Neither will any music or other sounds if kept at the same level as normal speech which is around 55 to 65 dB or thereabouts.
Cordially,
Neil
Hello there,
10 weeks ago I woke with sudden hearing loss which I initially thought was wax build up.
After no improvement a couple of days later, I went to see a hearing specialist who diagnosed SSHL and told me to see an ENT specialist immediately.
I was prescribed steroids but, the morning after, I awoke and my hearing had returned, although distorted. Two days later I started with severe tinnitus, like aeroplanes going overhead continuously. I also had headaches and slightly blurred vision. Altogether, I felt distant from reality. I couldn’t sleep, mainly due to the tinnitus, and couldn’t seem to manage to work a full day or socialise etc. It was extremely uncomfortable.
Looking back, I now remember a pain in my ear a day or two before. I didn’t last for long so I didn’t connect it at first. I also had a 3 hour flight 3 days before the SSHL happened.
I have recovered quite well, my hearing test is now normal, although I still have an intermittent buzzing sound after noises or when I speak. Like an echo. If I’m stressed it’s worse. If I had to spend the rest of my life like this it isn’t a problem at all, although, if it came back as it was initially it would be horrendous.
For this reason, I’m terrified of it coming back so I’m scared of flying in case it was the flight that caused it. I know the usual problems with flying is the pressure, and that is recoverable, but I’m worried in case mine was caused by something more than that. Maybe the constant reduction of oxygen during the flight?
How can I be sure the flight didn’t cause it and what can I do to reduce the chances of it happening again? Can I increase the oxygen in my body beforehand? I do have a low heart rate, 55 BMP resting during waking hours so could that have anything to do with it?
I forgot to mention, an MRI showed no signs of tumour.
I also had a little bit of dizziness the night before my hearing came back. It lasted about an hour or so.
I also now have moments when my hearing seems to change for a few seconds – I feel as if it’s gone quiet, but when I rub my fingers near my ear I can still hear very well. I then hear I high pitched ringing, not very loud. Then it fades away within a few seconds back to normal. This happens in both ears (strangely more in the opposite ear to the SSHL ear) although not at the same time. I’m not sure, but I think it’s related to moving my head, bending down etc.
I was also very stressed the day before the SSHL happened. And, two weeks afterwards, I also had a sharp pain on the top of my skull that came and went intermittently over a few days. That has now gone completely. I’m wondering if that could have been stress related or related to the SSHL.? Or even blood clot?
Many thanks
Carole
Hi Carole:
Some people have ear problems after they fly. I’m not sure what’s going on. The air pressure is lower as the cabin pressure is kept to the equivalent of being between 5,000 and 8,000 feet above sea level depending on the plane. Also the oxygen levels are lower (by up to 25%).
This, coupled with your slow heartbeat may cause less oxygen to reach your inner ears. The result could be temporary tinnitus and hearing loss. However, since you don’t experience problems until 3 days later, this doesn’t seem a likely scenario.
If you have clogged ears/Eustachian tubes/sinuses, you can get headaches and ear aches from the changes in air pressure. Again, I don’t think that was your problem.
One scenario might have been that in the close quarters in the plane, you might have caught a virus that attacked your ears in the days after your flight. You were even more susceptible to catching a virus since you were very stressed which shoots down the vitality of your immune system.
Viral attacks on your inner ears can result in tinnitus, hearing loss and balance problems. I wonder if that wasn’t the most likely scenario given the facts you have related. There may have been some other factors involved too.
So, if you want to fly again, make sure you are not in the midst of a cold, that your sinuses and ears are clear and calm down. It’s a good idea to yawn/swallow periodically as the plane ascends and descends so pressure doesn’t build up in your middle ears/Eustachian tubes.
I hope you don’t refuse to fly in the future because of one bad experience. I’ve flown numerous times without any ear problems.
Cordially,
Neil
Hi Doctor,
Two years ago, while 39 weeks pregnant, I went totally deaf in my left year. After giving births days later, I took predisone and a few steroid injections. My hearing was restored to about 50%. After speaking to several specialists in NYC, the SHL was probably due to the cold virus, which I had at the time, as well as, a fluid imbalance due to poor circulation. I’ve also had an MRI.
Recently, I’ve experienced, what I think is a decrease in hearing and increase of ear ringing. In addition, within the past days, occasionally I will have a zapping sound/sensation. Can you please tell me what this zapping is and if there is anything that I can do to improve?
Thank you for your help.
Sincerely.
Lynn
Hi Lynn:
I don’t know what your zapping sensation is in your case–don’t have enough information. However, if you have been on psychotropic drugs such as the Benzodiazepine class of drugs and then suddenly stop taking them without a slow taper, you can get a zapping sensation. Is this perhaps what has happened in your case?
Cordially,
Neil
Hi, I am a 36 year old male in pretty good shape. I flew to Asia end of september for business and spent 44 hours on planes in 5 days. Then after getting home a week later I took my family on vacation in Disney. On the 3rd day there (last Tuesday) I woke up and noticed I couldn’t hear well in my right ear and I felt fullness and had some ringing. I thought maybe I slept funny on it. The next day I had a hotel doctor look and he saw some redness and swelling in my ear canal and put me on antibiotics but it never made sense to me because I had no pain. I then flew home this past Saturday with no pain at all on the plane. I went today (Monday) to an ENT specialist in nyc . They gave me an Audiogram and noticed 60 dB hearing threshold only in low frequencies in my right ear then returning to normal by 1000hz. Interestingly in my good ear (left ear) low frequencies were also slightly worse then high producing the same shape Audiogram but pretty much all in the normal range and less dramatic. Doctor concluded it was either meneire”s disease (even though I have no vertigo) or idiopathic SSHL (virus probably). He put me on 60mg of presidone then weaning off after a week. It has been 6 days since I noticed the hearing loss until starting the steroids today. When I first noticed it on Tuesday I could not understand voices on the phone on that ear. But starting yesterday I could begin to understand voices although different sounding dial tone and ring in my affected ear. This was prior to staring the steroids today. As an aside I also noticed I seem to be able to hear a gentle faint heart beat swoosh more in my ears when it’s quiet then i used to before this sudden hearing loss but can’t tell if it’s just because I have heightened awareness now and am very focused on it. Just wanted to see if u have any thoughts on my condition and prospect for recovery. The ent specialist was hopeful for recovery given how I presented Thanks in advance
Hi V:
Numbers of people have complained of hearing problems after flying so it is not unknown. It usually resolves itself in a few days without any need for medical intervention. I wouldn’t be surprised if your hearing also comes back. I agree with your doctor that since it is already coming back, you have a good chance of most or all of it coming back in the next two weeks if not sooner.
Is your neck or face or jaw “tight”. That could be an indication that you have a Meniere’s-type condition–but not full-blown Meniere’s.
Concerning possible pulsatile tinnitus–the more you focus on it, the louder it appears to become. I’d totally ignore it for a couple of weeks and see what happens.
Cordially,
Neil
Hi doctor thanks so much for your reply and what a great forum you have. A couple updates/ replies to your questions. It’s now been about 36 hours of steroids and its 8 days after I lost the hearing in my right ear, and although I haven’t taken an updated audiogram I just know it’s much better. I can’t really even notice much of a difference in listening to the tv when I lay on one side or the other. My ear doesn’t feel full anymore either. I can’t be sure if I recovered low frequency hearing but I have to imagine it’s better. Yes the dial tone does still sound little different in both ears but volume now is similar. As for neck or jaw pain, I actually am a clencher and from time to time I get some jaw pain but not recently. Doctor did think meneires was a possibility but I’ve had no vertigo. My grandma has meneires my parents just informed me so that’s definitely a possibility i guess. He also thought a possibility given my good ear showed some slight loss in low frequency which he said is common in meneires the other ear shows a trade amount. Neck pain though is fairly consistent for me. Given my job I am constantly on my smart phone typing or at a computer. Also I’ve had some neck alignment issues in the past. I’ve been told that my trapezoids get extremely tense also to the point it may limit blood supply. I’m wondering maybe I should get some chiropractic help and wonder if that could have contributed to this?Besides flying I had my very big for her age 5 year old daughter on my shoulders in Disneyworld watching a show the night before I woke up with this and it definitely made me neck very sore. Lastly on the pulsatile tenitus in the good ear it does seem to come and go and less I focus on it better it’s seems. This is going to sound really bizarre but I’ve noticed when I move my neck a certain way and hold it there it actually stops or gets louder depending how i shift my neck. Appreciate your insights doc.
Hi V:
It looks like you have a good chance of getting all/most of your hearing back. That’s the good news. However, all the extra information you have given me tells me that your neck is definitely out of proper alignment. Medical doctors don’t know this, but Meniere’s disease is caused by your C1 and C2 vertebrae being out of proper alignment–so fixing Meniere’s is as simple as going to a special kind of chiropractor–an upper cervical chiropractor. They can precisely align those two top vertebrae which takes the pressure off the vestibulocochlear nerve and your inner ear starts working properly again.
To learn all about this and to find an upper cervical chiropractor read my article on the subject at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ . I’m sure some other vertebrae are also out of proper alignment. You may need regular chiropractic care in the future to keep your upper cervical spine in proper alignment given your work, etc.
It is not strange for pulsatile tinnitus to temporarily stop as you have found when you hold your neck in a particular way or press on certain spots in your neck area. This is because holding your neck in a certain way relieves the pressure on an artery near your ear so blood flows normally and hence the pulsatile stops, or you stop the blood flowing temporarily (pressing does this too) and so you don’t hear the turbulent blood flow (which is what pulsatile tinnitus really is).
Cordially,
Neil
This is excellent information. I am going to find one such chiropractor! Thank u! I will keep u and the board updated.
Hi doctor, just an update. I was pretty sure my hearing was back to normal in my right ear even at low frequency so I moved up my follow up appointment and took another hearing test yesterday and I was correct, totally back to being same in both ears. Both ears struggle a bit at low frequency it seems but still near or just below the 20db line. He advised me to stay on the steroids and finish out the course. I am still hearing the low pulsing in my left ear (the good ear where I didn’t get the sshl) when it’s quiet. I’m pretty sure it’s my blood flow I’m hearing in it. I think it has to all be related. It gets louder and more constant and less pulsitile when I rotate my head in the opposite direction of the ear. I took your advice and have an appointment with a chiropractor who says they do upper Cervical work a lot. My ent doctor listened to my jugular and didn’t hear anything unusual and he was not overly concerned about the pulsing in my other ear but he didn’t think it was related to my sudden hearing loss which I disagree with. He did say if it was still bothering me in a month he would get me an angiogram CT just to put my mind at ease. Too coincidental though for me to think unrelated. Any further thoughts u can share most appreciated. I’m very grateful my hearing is back in less then 2 weeks of onset but I’m also wondering what happened and why I am suddenly noticing this very faint pulsating woosh in my “good” ear and if that fact I have very slight low frequency weakness in both ears. As a reminder I am constantly looking down for my work on my phone. I know I have horrible text neck. Tend to look down and to the right when I type on it because I’m right handed. My hearing loss was in my right ear but the pulsitile woosh is in my left and it gets louder and more constant when I look right and down. Thanks again! Ps- this is an amazing sight, do u take donations ?
Hi V:
Glad things are working out for you. I hope the upper cervical chiropractor ends your neck problems.
PS We are always glad to receive donations to help keep the work of the Center going–including this website. The easiest way to make a donation is via PayPal or send a check. My email and address are at the bottom of any page on this website.
Cordially,
Neil
Hi doc, just an update and a question: My hearing in my right ear has completely returned (I am very grateful) and I am beginning to be weaned off the prednisone. My question is as I finish the steroids is there a chance my hearing regresses some?
Hi V:
Unless you have an autoimmune disease, I don’t think your hearing will regress at all just because you come off the Prednisone. I’d be hopeful that your ears will be normal (or near normal) going forward.
Cordially,
Neil
Hi Dr,
Just an update /question. So my hearing is back fully in my right ear and the pulsatile tinnitus I had in my left ear is definitely much better however I still hear the rythmic swooshing when I lay that ear in my pillow at night. Just wondering if u had any thoughts if that eventually will go away or what it could be. My doctor listened to my arteries and said they sounded great. No bruits. Thought might just be a normal anatomical variation or something along those lines. When I asked about an anyeurism he really down played that worry. He also listened to the back of my ear with his stethoscope and heard nothing. Any thoughts?
Dear Doctor Neil,
I’m sorry to bother you but I am a 37 year old male that woke up with ringing in my right ear on October 18th. I went to see a doctor on October 22nd and they told me that they couldn’t do anything about it. I went to see another doctor in a larger hospital on the 25th and he put me in the hospital and gave me steroid treatments for the next 5 days. From the hearing test, it seemed like I was gaining some hearing back but at a very slow rate. I was let out of the hospital on the 30th and followed an oral steroid treatment at 5,4,3,2,1 pills from one day to the next. I gained some more hearing back but my high frequency isn’t doing too good. It is now 11/08 and I do not know if I am improving at all. The doctor has me going back a month later. He seems to be hopeful that I will gain all of my hearing back. I still feel like my ear is stuffed up with ringing all the time but I can hear in my right ear. However it isn’t as clear as my left ear. Can I expect it to gradually get better?
I read that you said after 30 days there will not be any more improvement. Is that 30 days since it happened or 30 days after the treatment?
I’ve also included my hearing test results.
I’m Sorry for all of the questions.
Hearing test (10/25, 10/29, 11/06)
Frequency 250
right ear: (10, 15, 10)
left ear: (25, 20, 10)
Frequency 500
r: (15, 20, 10)
l: (35, 30, 10)
Frequency 1000
r: (5, 15, 10)
l: (20, 30, 15)
Frequency 2000
r: (5, 5, 0,)
l: (30, 15, 10)
Frequency 4000
r: (15, 10, 0)
l: (45, 40, 20)
Frequency 8000
r: (20, 20, 20)
l: (50, 50, 45)
I’m sorry I have mixed up the right and the left in the chart.
Hi Jimmy:
Your hearing has come back rather nicely. You are now in the “normal” range for both ears, but you right ear is a bit low at 8000 Hz.
Normally, the 30 days starts from the day the hearing loss occurs. I doubt you will get much more back now–but you have very good hearing now except for your right ear at 4 and 8 kHz. That may make it sound like you can’t hear as well as you used to. Your tinnitus is probably as a result of your high frequency hearing loss–and you most likely have a lot of hearing loss in the frequencies above 8 kHz where they didn’t measure, but the associated neurons in your brain know–and as a result you have tinnitus.
Cordially,
Neil
Dear Dr Neil
I would be grateful to get your professional opinion on my situation. Apologies in advance for the long post ahead.
I woke up one morning in April this year with a blocked sensation in my left ear. Didn’t think much of it as I assumed it was some kind of pressure imbalance thing going on & that it would crackle and eventually ‘burst’. After 2-3 days started to worry a bit as there was no crackling at all, despite chewing, yawning, blowing nose etc. It was like the ear was ‘dead’. Furthermore, I felt numbness inside and all around the ear spreading to halfway across my face and also my head. But no pain or discharge. Didn’t notice any ringing at this time either but it may been there, just didn’t notice it. Tried some off-the-counter hydrogen peroxide eardrops for a few days – no effect. After a week of no improvement – in fact the numbness felt worse, and also the clogged feeling – & a realisation that I was in fact deaf in that ear (rather than just clogged) as upon closing my good right ear I could not decipher what anyone was saying to me even when they were only mere inches away – I called my GP (general practitioner – I’m in the UK), described the symptoms; he told me it was probably earwax (Bear in mind this was during early part of lockdown and non-essential visits, medical or otherwise, were limited so it was only a telephone consultation, not a physical one) and to get some olive oil drops to try for ‘1-2 weeks’. So I did – no improvement whatsoever. By this time (3 weeks in) I was very worried, especially since I was starting to notice other symptoms too, mild ringing in the ear and also some vertigo when I looked upwards or stood on a chair. Called my GP again, asked if I should go to the hospital for emergency treatment, was told ‘no’ but to go into the clinic for a physical examination that day which I did. A clinician inspected my ear, saw redness & inflammation (there was mild pain inside the ear by this time but barely noticeable), she concluded it was an outer ear infection, prescribed Otomise spray for a week. No effect – still clogged, very bad numbness in and around ear and half of face and head, ringing. And deaf. Went back in to see her the following week, she said she could see the infection was now dry and crusty, and turned yellow. She also took a swab test and this time prescribed amoxicillin to be taken orally for a week. No improvement. Went back in to see her the following week, the outer ear infection she could see was better but no bacteria grew on the swab test. At this point she made an ‘urgent’ referral to an ENT consultant who I saw the following week 26 May, over 6 weeks after I woke up with this problem.
There I did an audiogram test which showed severe hearing loss in that ear (2 khz -50db, 4khz – 65 db, 8khz – 85 db). The consultant informed me that I have sudden sensorineural hearing loss. Prescribed prednisolone 60mg for 5 days with taper to 8th day. No improvement. Went back for a follow up, this time with a different consultant. Audiogram – similar results to before. I declined the steroid injection treatment having already read that such treatment was unlikely to be helpful 7.5 weeks later. Went for an MRI scan – awaiting results.
Neither consultant was able to say what the cause of my issue was other than that it was probably a viral attack, including possibly even Covid 19 (apparently there’s been an uptick of SSHL cases recently). Although it is a possibility I am sceptical as I did not have a cold/ flu in the run up to this incident nor any of the typical Covid-19 symptoms. In fact I felt healthy at the time. The only strange thing occurring a few weeks before my hearing loss was I was losing masses of hair & continued to do so until only a week or so ago. I put it down to perimenopause at the time (I’m 52) but maybe it was connected to my hearing loss, I don’t know. I also did have a very bad chesty cough in early January that lasted all month but unless I do the antibodies test I won’t know if I’ve had Covid 19 or not and in any case that was a good 2 months before my hearing incident.
To my mind a more likely cause was a neck trauma. I took up yoga in the week leading up to this incident to help alleviate the neck and back pains I’ve suffered on and off for many years (I have a longer spine than normal, and more S-shaped too, and a long neck). I do remember deliberately over-stretching my neck when doing a couple of yoga positions (Cobra and Plough) thinking this would help to exercise the area more, but I may have inevitably damaged something by exerting too much pressure on the neck. The Plough position which involves lying on the back and lifting both legs over and above the head is particularly strenuous on the neck. But if I had done damage I did not realise it (until I lost my hearing) as my neck felt normal afterwards. The first consultant (I did not mention to second consultant) didn’t seem too persuaded by this theory. I had the impression both thought it more likely to have been a viral infection (perhaps because an infection was seen in the outer ear?). I would be interested in your thoughts on this theory as I have seen some of your posts about how misalignment of the upper cervical spine could be the cause of SSHL.
Current status some 10-11 weeks later is a full/ clogged feeling still (which I find the hardest to deal with), mild tinnitus, no more numbness (though this did last around 8 weeks). No vertigo/ balance issues. But I am now also for the first time experiencing crackling noises in that ear when I chew or yawn. This started a few days ago. I keep hoping it will burst but I think it is a false hope. Also when I press the lower area behind my ear (where it joins with the head) there was some pain there but now appears to have receded. Do I now also have something else going on, this time maybe in my middle ear??
So in summary, my questions are:
1. I’m trying to understand how the outer ear infection (visible swelling/ inflammation) ties in with the inner ear problem which might, through maybe a process of elimination, give me a clue as to how my hearing loss happened. If I’d indeed damaged a nerve doing yoga, presumably this would have started as an inner ear problem first but could it then have spread to cause inflammation in the outer ear too? Or did it start first as an outer ear infection which then spread to the inner ear, which presumably makes it more likely to have been a viral attack?
2. Why am I now experiencing crackling noises in that ear? And also some periodic mild pain behind the ear?
Thanking you in advance for taking the time to read my long post. Most grateful for any of your views on my situation.
Best regards
Jackie
Hi Jackie:
After reading your “epistle”, I think I agree with you that your problems are very likely related to your vertebrae being out of proper alignment. That would explain all your ear problems and the numbness in your face too.
I think the infection business was just a red herring to the real problem. I don’t think they are related to each other apart from both being in your body.
When you relax more, the symptoms are less and when you are “uptight” your muscles tighten and pull your neck off more and thus pinch the nerves more resulting in worse problems. I think this also explains the crackling sounds which are just air trying to get through your Eustachian tubes because your neck being “out” also affects the nerves controlling your Eustachian tubes.
My suggestion would be to go to an upper cervical chiropractor. I only see 3 listed for England. You can see them at http://www.upcspine.com/prac3.asp?rid=3&r=Europe&sid=84&s=ENGLAND&cid=6&c=UNITED%20KINGDOM
Cordially,
Neil
Dear Dr Bauman
Thank you for your reply and for taking the time to read through my long post and provide advice. I will see my GP in the first instance and discuss with them about seeing an upper cervical chiropractor.
If I may trouble you with one more thing. When it permits, I will need to fly a few times in the year, both long (15 hours) and short haul. I have never had any serious problems with my ears when flying other than occasional pain and blocked feeling during takeoff/ landing that clears after a few hours. But now I am terrified of losing hearing in my good right ear (which also has moderate hearing loss) and wish to protect it if I can. I have read that wearing earplugs especially during takeoff and landing is helpful but this is something I have never done before -and I’ve flown hundreds of times – and worry that doing something different now might in fact make things worse since my ears are not ‘used to it’. Or is it always good practice to wear earplugs on planes?
Thanks again
Best wishes
Jackie
Hi Jackie:
Over here a GP would never recommend a chiropractor. So don’t be surprised if he downplays this.
I don’t see that flying as such is a problem for your ears. I’ve never had problems with my ears either in all the times I’ve flown. The caveat is that if your ears are congested, not a good idea to fly. I hear from people that have problems at those times.
One way around it is to take a decongestant about an hour before you take off and another an hour before you touch down. But not necessary if your ears are clear.
Using the earplanes earplugs slows down the rate of pressure change. This is particularly useful for people that have large vestibular aqueduct syndrome. Otherwise when ascending and descending just swallow or yawn periodically (or chew gum) to keep your Eustachian tubes working and equalizing the air pressure.
Cordially,
Neil
Hi Dr Bauman
Thank you for your reply. You have been most helpful and reassuring.
Best wishes
Jackie
Thank you for any insight you can provide. I am a 78 year old female and have had four episodes of temporarily losing my hearing in my left ear. The first episode was in Nov. 2020. I was in bed watching TV and rolled over to my right side and realized I couldn’t hear the TV. I quickly googled and discovered Sudden Hearing Loss and saw where steroids were used. Having no steroids, I took two Naproxen.
The next morning there was still hearing loss but seemed minutely better so I took an Ibuprofen and continue taking it every four hours. In a couple of days, I felt like it was completely restored.
Then in December, I had another episode and repeated the same drugs. In two days, even though there was improvement, it wasn’t 100% so I made an appointment with an ENT doctor. I explained everything, but it was obvious he did not comprehend what I was saying. He said I had wax in my ear and maybe it moved and blocked my hearing. I assured him that didn’t happen. He cleaned my ear and said if I experienced hearing loss again to see an Audiologist for a hearing aid.
Fast forward to today. This is my second episode since I saw the ENT. I have repeated the Naproxen/Ibuprofen routine and most of my hearing has been restored…been two days…but the hearing in my left ear is not quite as clear as my right ear.
It’s concerning that it continues to happen. Would a treatment with steroids help prevent it from recurring? Is there any supplement I should be taking. I fear that if it continues to happen, I may eventually completely lose the hearing in my left ear.
Thank you for any advice you can offer.
Nancy Hoffman
Hi Nancy:
You shouldn’t be getting periodic episodes of hearing loss. This shows that something is wrong. The first thing I’d want to know is what your audiogram looks like when you experience one of these episodes–whether it is a low-frequency hearing loss, a more or less flat loss, or a high-frequency hearing loss.
Second, do you have any tightness in your head or neck?
Third, did you ever have any head trauma or were in a car accident in the past 25 years or so?
Fourth, do you have any balance problems or dizziness associated with these episodes?
Steroids probably won’t prevent such episodes from happening, but they may be helpful in getting your hearing back when they do occur.
I need to know much more about your situation before I can really point you in the right direction.
Cordially,
Neil
I’m 17. About a month and half ,my right ear suddenly started ringing and i felt dizzy for two days after the onset . I went to the doctor when he told me I had some fluid and prescribed me medication for the same. I had them for 20-25 days and after no improvement after a certain amount i was worried and went to another doctor. He asked me to get some tests done and then after 3 weeks of onset i discovered i had SSHL in my right ear. They told me to go for steroids immediately. I took some oral ones for 10 days and now here I am with no effect at all. When i went to the doctor again he said he had no cure and all i could do was to use a hearing aid to amplify the sound a bit.
Can you please tell me if there is any hope or anything i could do now to try to bring some hearing back? Or to resort to anything except a hearing aid.
Hi Ari:
I suspect that you had a viral attack on your right ear that caused the hearing loss and dizziness. Viral attacks have to be treated within 3 days in order to be effective.
Since is is 45+ days later, I’m afraid that your doctor is right and that your hearing loss will prove to be permanent.
You can do nothing, and hear from your left ear, or you can use some sort of amplification–a hearing aid or some sort of assistive listening device. That’s all that is available at present. Sorry.
Why don’t you want to wear a hearing aid? Wearing one is less noticeable than always saying “what?” and asking for repeats or making off the wall comments because you didn’t understand what someone was saying to you.
Cordially,
Neil