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One minute, everything sounds completely normal. Then in what seems like an instant, you're on the other side of a wall. You have sudden sensorineural hearing loss (SSNHL), also known as sudden deafness or acute hearing loss.

What is acute hearing loss?

Hearing loss may begin suddenly, without any apparent external cause. To be more precise, this is a particular type of hearing loss. The sounds that reach the ear are no longer converted into nerve impulses sent to the brain, as they would be in a healthy ear.

Symptoms often occur in one ear only, and are not accompanied by pain. The hearing loss may be so minimal that it goes unnoticed, or so great that it results in complete deafness. Acute hearing loss can affect anyone.

How can acute hearing loss be identified?

A few, typical symptoms are used to identify hearing loss. Hearing loss or "incorrect" perception of sounds can develop suddenly, from one moment to the next. The world around you sounds quieter in one or both ears. Voices and music can suddenly sound different, or strange. Everything sounds as if it were wrapped up in cotton wool. You might also hear “double” sounds.
You may no longer be able to tell where a particular sound is coming from. Those with acute hearing loss typically describe feeling a furry sensation around the auricle, or pressure on the ear. Problems such as tinnitus may also occur. In rare cases, the hearing loss may be accompanied by feelings of dizziness.

What causes acute hearing loss?

Although the specific cause is unknown, several theories exist. Medical professionals suspect that it involves a circulatory disorder in the smallest blood vessels of the inner ear, which is why the illness is also referred to as an acute hearing loss. Another hypothesis is that hearing loss is due to inflammation or a virus (e.g. from a middle ear infection). The tissue around the sensory organs may become inflamed during an infection, which may damage the hearing.
Some viruses affect the nerves. If the cochlear nerve is affected, hearing is impaired. Stress is also regarded as a potential trigger that can, as a minimum, contribute to the harmful impact of the disease. Patients often state that they were under extreme stress before the symptoms occurred. In some people, stress has a negative impact on physical functions and may therefore also affect the ears, which are known to be particularly sensitive.

What to do in the event of acute hearing loss?

Between 40 and 100 people out of 100,000 are affected each year by acute hearing loss. Their ability to hear decreases dramatically from one moment to the next, usually in just one ear. Severity can vary from a dull feeling, as if everything had been wrapped up in cotton wool, to noises inside the ear such as tinnitus, to profound deafness. We have summarized here the possible treatments, and listed the cases in which you should definitely seek medical advice.

Wait or seek treatment?

Although hearing loss doesn’t represent an emergency from a medical point of view, it is advisable to treat it proactively. If you notice one or more of the symptoms described here, you should contact your ear nose and throat doctor. In around 50 percent of cases, normal hearing returns within 24 to 48 hours. It can generally be assumed that the lower the intensity of hearing loss, and the shorter the period, the more successful the treatment is likely to be.

Acute hearing loss treatments

Remember, there is no single ideal treatment. However, three types of treatment have proven to be effective.
This anti-inflammatory is administered either as a solution or in tablet form, and is intended to treat swelling in the inner ear that may be the source of complaints.
Intratympanic Therapy
Cortisone can also be used in a targeted way by the administration of a higher concentration of active ingredient directly at the site of the complaint. Using a very fine needle, the doctor can spray cortisone directly into the middle ear.
Treatment with substances such as hydroxyethyl starch (HES) has also proven to be successful. It improves blood flow, thus boosting circulation in the inner ear.

The above treatments typically attain positive results, with hearing almost fully restored in most cases. However, between 10 and 20 percent of those affected will continue to have some hearing loss. A hearing aid can help in such cases.

Diagnosing acute hearing loss

A diagnosis is made according to the exclusion principle: All other potential diseases of the ear are ruled out before diagnosis. An examination starts by asking the patient the following questions. When did the hearing loss begin? What are the symptoms? Was the patient exposed to noise? Does the patient have a pre-existing condition (e.g. diabetes)? What medications are being taken? Is the patient stressed?
The ear is then examined visually using an otoscope to ensure that the hearing loss is not the result of a blocked ear canal or damaged eardrum. Other methods may be applied at the doctor’s discretion. Various hearing tests may be performed to test the patient’s sense of balance, and blood pressure is measured. None of these examinations are painful.

Can acute hearing loss be prevented?

If the illness appears to be the result of a circulatory disorder, the same rules apply as those for preventing a heart attack. A healthy lifestyle is important. This involves avoiding stress, sticking to a healthy diet, and doing sufficient exercise, as high blood fat levels can impede blood circulation. Nicotine is also harmful to the blood vessels, which is why patients are advised to give up smoking.
In addition, very loud noises should be avoided. Suitable ear protection should be used in case of continued exposure to noise, for example at a concert or nightclub. In the event of prolonged exposure to noise (due to having a specific job, for example), having customized ear protection is the best way to help.

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