Sudden Onset Sensorineural Hearing Loss (SSHL)

SSNHL by definition is a hearing loss of at least 30dB over 3 frequencies within 3 days. The symptoms are

  1. Hearing loss of sudden onset, usually involves one ear only
  2. Sensation of fullness, blockage, no acute pain usually although some patients experience ear discomfort
  3. Tinnitus in the affected ear
  4. Dizziness occurs in some patients

The treatment is aimed at restoration of hearing. Generally it includes

  1. High dose oral corticosteroids.
  2. Oral antivirals – evidence of its effectiveness is mixed in the literature
  3. Intratympanic dexamethasone injections – involves making a small hole in the eardrum under local anesthesia and injecting steroids into the middle ear. This is done in the hope that some of the steroids will enter the inner ear through the round window of the labyrinth. Usually given 4 times, once every 2 to 3 days.
  4. Hyperbaric Oxygen Treatment (HBOT) – patients are placed in a hyperbaric chamber when oxygen pressures are increased in the hope that higher partial pressures of oxygen will help reverse the hearing loss. Requires up to 25 daily treatments and is costly.

The success of treatment depends on a few factors

  1. Starting treatment as soon as possible – treatment should commence within one week from onset of symptoms, not later than two weeks
  2. Hearing loss more than 70dB is a poor indicator, better than 50dB is a good indicator
  3. Low tone hearing loss recovers better than high tone hearing loss
  4. Dizziness is a poor indicator
  5. Diabetes Mellitus is a poor indicator