Urgent action is needed in the case of sudden hearing loss - Andy Armitage

There are not many hearing emergencies that require someone going to A&E, but sudden hearing loss is definitely the main one. The professional term is Sudden Sensorineural Hearing Loss (SSNHL) and is one of the few genuine hearing emergencies.

Many people mistake it for ear wax or congestion and dismiss it, but this can be the wrong assumption to make, and early diagnosis and urgent treatment can significantly improve the chances of recovery.

It affects approximately 5 to 27 per 100,000 people globally, although as many cases are not recorded, this figure is likely to be much higher. It most commonly affects adults between the ages of 30–60 years and generally affects only one ear. Roughly 70 per cent of cases also get tinnitus (ringing in the ear) and slightly lower at 50 per cent, some people experienced balance problems and/or vertigo (spinning sensations).

So what exactly is it? For most people it is a sudden and rapid loss of hearing which is caused by damage to the inner ear or hearing nerve. Symptoms can occur within a few hours or can take up to 72 hours to show themselves. The clinical definition is a hearing loss of 30dB or greater across three consecutive frequencies within three days. Ear wax and congestion take much longer to impact someone’s hearing, so it is a noticeable change to look out for.

The key symptoms to look out for are initially experiencing sudden hearing loss in one ear. Often upon waking up people have difficulty hearing properly from one side. It can feel like a blocked, muffled or ‘underwater’ sensation that comes on suddenly. Other symptoms include sudden onset tinnitus in one ear or dizziness or vertigo alongside the hearing loss. What is most important to look out for is a sudden and noticeable difference in hearing between the two ears.

Unlike wax, SSNHL originates in the inner ear and cannot be seen by looking in the ear canal. It needs to be treated as an ENT emergency, and the current practice is to prescribe high dose steroids as quickly as possible. If the treatment is started early, the impact is also very quick, however, by waiting several days or weeks can reduce the chance of successful treatment.

Research suggests patients receiving steroids within seven days were around five times more likely to achieve full recovery than those who did not receive steroids. However, despite steroids being widely used, there is still uncertainty about the best way to deliver them. The UK is currently running the STARFISH Trial (STeroid Administration Routes For Idiopathic Sudden Sensorineural Hearing Loss). The trial is comparing steroid delivery methods including by mouth or injection, or a combination of both treatments.

So what do you need to do in the event of sudden hearing loss? First and foremost, even if you have previously had problems with ear wax, do not just assume that is the problem. Seek urgent medical attention the same day, through contacting your GP, NHS 111, urgent treatment centre or ENT service via A&E. Explain clearly that the hearing loss was sudden in onset and request an urgent hearing assessment.

Through taking these actions either for yourself, or a relative, you could literally be saving their hearing longer term. Regular hearing checks can also help you monitor your hearing, in the same way that people go for eye appointments.

Andy Armitage is a director at The Yorkshire Hearing Clinic.