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How is it Treated?

Treatments for Sudden Sensorineural Hearing Loss (SSNHL)

If you are diagnosed with Sudden Sensorineural Hearing Loss (SSNHL), it is important to begin treatment as soon as possible.

The flow chart below shows the suggested treatment process based on the best available evidence.

Flow diagram showing the suggested process for the management of sudden sensorineural hearing loss (SSNHL). Diagram inspired by ‘Controversies in the management of sudden sensorineural hearing loss: an evidence-based review’, Lawrence, R. & Thevasagayam, R. Clin. Otolaryngol. 2015, 40, 176–182.12 December 2014.

The current recommended treatment is a course of high dose corticosteroids, which may be taken in pill form, administered intravenously, or injected directly into the ear, depending on the healthcare system where you live. This type of steroid medication can help the body fight illness and reduce inflammation in the inner ear.

You may be treated as an outpatient, or you may need to stay in the hospital while receiving treatment, so any changes in your condition can be monitored.

You May Also Be Prescribed:

  • Antiviral medication – if the doctor suspects the hearing loss could possibly be caused by a virus
  • Antibiotics – if the cause of the hearing loss is possibly due to an infection
  • Vasodilators – this type of medicine can help improve the blood supply to the cochlear (the hearing organ)

It is crucial to start treatment very quickly after the onset of SSNHL, ideally within 48 hours or less. The earlier you receive treatment, the better the chances of restoring your hearing.

How Long Will the Treatment Last?

High dose steroid treatment has the best possibility of regaining hearing during the first two weeks, and treatment should be continued up to 6 weeks. You may require a repeat course of steroids.

What Other Tests Will Be Done?

  • An MRI scan should be ordered to look for any abnormalities in your ear. MRI takes detailed pictures of your brain and inner ear, which can help your doctor find the underlying cause of SSNHL. Sometimes a CT scan may also be performed.
  • Blood tests may be performed, which can help to rule out certain causes of the hearing loss, in some cases.
  • You may carry out tympanometry. This is a test that measures the function and movement of the eardrum and middle ear. Acoustic reflex testing may also be carried out, which can provide information about or confirm the type and degree of hearing loss. You will need to sit quietly for these tests. A probe with a flexible rubber tip (like an earplug) will be placed in your ear. During the test, it will feel similar to the pressure changes during take-off and landing when you’re on a plane, and you may hear a low-pitched tone. For acoustic reflex testing, you will be presented with a series of loud sounds. These can get quite loud, so if they are uncomfortable, let the hearing healthcare professional know.

Are There Other Treatments Available?

Initial treatment of SSNHL should always be a course of corticosteroids. You may also be offered other treatments to help regain hearing, in addition to steroid treatment.

Intratympanic (IT) Steroid Injection

This is an injection of a small amount of steroid directly into the middle ear. This way of administering steroids is sometimes used as the main treatment (particularly if you are unable to take steroid medication orally) or can also be used in addition to oral steroids.

Sometimes patients with no recovery after oral steroids are given up to three steroid injections, at one-week intervals, in an attempt to recover some hearing.

– Hyperbaric Oxygen Therapy (HBOT)

You may be offered Hyperbaric Oxygen Therapy (HBOT), together with the steroid treatment. This therapy is typically performed as an outpatient procedure.

HBOT involves breathing pure oxygen in a pressurized environment. When your blood carries this extra oxygen throughout your body, it helps to promote healing.

You will be asked to lie down on a table that slides into a clear plastic oxygen chamber, or in a room designed to accommodate several people where you receive oxygen through a mask over your face.

Typically, the therapy is done daily for 90 minutes, for 10 to 20 treatments, depending on your response.

Will I recover?

Recovery from SSNHL will depend on a variety of factors such as your age, the cause of the hearing loss and how badly you were affected.

Some people may partially or completely recover their hearing, but for 32%-65% of patients, their hearing does not recover.

If you don’t recover any hearing, there are hearing aids and implants that can help assist with amplification of sound, hearing in background noise and reducing any sounds of tinnitus that may be present. You may also need to adjust the way you and your loved ones communicate.

Emotional Effects of SSNHL

You may experience emotional aspects of SSNHL such as the feeling of loss, anxiety, or shock.

Online support group: Three white mobile phone screens showing images of group therapy on blue background.

For help with the emotional aspects of suddenly losing your hearing, you can seek help, advice, and information by:

Emotional recovery from SSNHL can take time and sometimes it involves changing your daily routines to accommodate this. It is important to get as much support as you can.

Sources:

https://www.hearinglink.org/your-hearing/sudden-sensorineural-hearing-loss/
https://rnid.org.uk/information-and-support/hearing-loss/types-of-hearing-loss-and-deafness/sudden-hearing-loss/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928516/
https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380
https://www.healthyhearing.com/report/33583-What-is-tympanometry-and-how-is-it-used
https://pubmed.ncbi.nlm.nih.gov/29769117/

Acknowledgements:

Many thanks to Roulla Katiri, audiologist at The Mater Misericordiae University Hospital, Dublin, for proofreading and editing support.