Prof. Dr. Gediz Murat Serin – Ear Nose Throat Specialist
Sudden hearing loss is a hearing loss that mostly occurs in one ear and progresses rapidly within a few hours or a few days. Patients often present with the feeling of “suddenly the ear closed.”
This condition is an emergency ENT problem; accurate diagnosis and rapid treatment are of great importance for the recovery of hearing.
This condition, which is much more common in society than estimated, especially occurs in the middle age group (40–60 years); however, it can be seen at any age.
Which Symptoms Suggest Sudden Hearing Loss?
Patients often describe their complaints as follows:
- Sudden decrease in hearing or complete closure sensation in one ear
- Noticing a significant hearing decrease in the ear upon waking up in the morning
- Difficulty hearing the phone in that ear
- Sounds coming muffled, whispered, or echoing
- Ringing, buzzing, pressure/fullness in the ear
- Dizziness accompanying sudden loss
- Decrease in hearing after hearing a “click” or “pop” sound
If even one of these symptoms is present, evaluation by an ENT specialist on the same day is required.
What Are the Causes of Sudden Hearing Loss?
In most cases of sudden hearing loss, no obvious cause is detected and this condition is called idiopathic. However, underlying factors can be identified in some patients:
- Viral infections (especially after flu)
- Disruption of inner ear circulation
- Trauma (head injury, sudden pressure change)
- Autoimmune inner ear diseases
- Ototoxic drugs (e.g., chemotherapy drugs)
- Auditory nerve tumors such as acoustic neuroma
- Neurological diseases (e.g., MS)
- Ménière’s disease
- Conditions related to high blood pressure, diabetes, and high cholesterol
Important Note: Nasal congestion, earwax, or sinusitis can also lead to decreased hearing, but these are “conductive type” losses; they are completely different from sudden sensorineural loss.
How Is Diagnosis Made?
The evaluation that must be done without delay in sudden hearing loss consists of the following steps:
- Otoscopic examination: The ear canal and eardrum are examined in detail. Conditions such as earwax, infection, or fluid in the middle ear are ruled out.
- Hearing Test (Audiometry): The type and degree of loss are determined.
- MRI imaging for inner ear – auditory nerve if sudden hearing loss (must be checked)
- If necessary:
- Tympanometry
- Balance test can be performed depending on suspicion.
Correct diagnosis by a specialist is critically important for treatment selection.
Treatment Methods
Treatment timing is as important as the treatment itself.
The first 48–72 hours is the period with the highest success rate.
1. Steroid treatment (First choice)
- Oral corticosteroid
- Intratympanic (through the eardrum into the middle ear) steroid injection
In some patients, both methods can be used together. Cortisone helps hearing return by reducing sudden inflammation and edema in the inner ear.
2. Cause-specific treatment
- Cleaning if there is earwax
- Antibiotic or antiviral treatment if it is infection-related
- Discontinuation of ototoxic drugs if present
- Regulation of blood pressure or sugar control
3. Cases where recovery is insufficient
If hearing loss becomes permanent, according to the patient’s needs:
- Hearing aid
- Cochlear implant (bionic ear)
can be evaluated.
Recovery rates
- In approximately 80–85% of patients receiving early treatment, hearing returns partially or completely.
- In those not receiving treatment, spontaneous recovery is around 50%, but full recovery is lower.
Conclusion: Don’t Wait, Apply Early
Sudden hearing loss is not a condition that “can be waited to pass.”
Every hour of delay may reduce the chance of recovery.
If you experience sudden hearing decrease, ringing, or fullness in one ear:
Consult an ENT specialist on the same day.
With early diagnosis and rapid treatment, most patients can largely regain their hearing.
