Sudden Hearing Loss: An ENT Emergency
Waking up to muffled or lost hearing in one ear can be alarming—and it should be.
Sudden sensorineural hearing loss (SSNHL) is an ENT emergency. Prompt recognition and treatment makes a big difference in recovery.
What Is Sudden Sensorineural Hearing Loss?
Sudden sensorineural hearing loss (SSNHL) is a rapid loss of hearing, most commonly in one ear. It can occur rapidly, within seconds, or can be more gradual, over the course of days. Unlike the temporary “clogged” feeling from wax or fluid, SSNHL involves the inner ear (cochlea or cochlear nerve).
Common early signs include:
Ear fullness or pressure (sometimes the only symptom)
Muffled hearing or sudden “dead ear”
Ringing (tinnitus)
New imbalance or vertigo
Because the symptoms can mimic an ear infection or fluid behind the eardrum, it’s easy to misread them. If you notice sudden hearing changes, seek care immediately.
What Causes It?
In most cases, the cause of the hearing loss is not determined, but research points to a viral infection leading to inflammation of the inner ear as the most common cause. Less often, SSNHL can be caused by:
Autoimmune inner ear disease
Blood-flow problems
Rare tumors such as acoustic neuroma
While rare, it is recommended to get an MRI to rule out acoustic neuroma in cases of sudden sensorineural hearing loss.
How We Treat Sudden Hearing Loss
Early treatment offers the best chance to recover hearing. We typically start as soon as possible, ideally within the first 14 days.
1. Oral Steroids
A prescription course of high-dose oral corticosteroids (like prednisone) is the first-line treatment. Steroids calm inner-ear inflammation and hopefully help to restore hearing.
2. Steroid Injections (Intratympanic)
Steroid can be injected directly through the eardrum (intratympanic), delivering the medicine exactly where it needs to go. There are two instances when this can be recommended:
Salvage therapy: Intratympanic steroid injection can be a rescue option when oral therapy doesn’t bring full recovery.
Primary therapy when needed: Sometimes oral steroids aren’t tolerated well due to side effects like anxiety, insomnia, or high blood sugar, especially in patients with diabetes. For patients who can’t safely take oral steroids, injections can be offered as first-line treatment.
Both treatments aim to reduce inflammation and protect delicate inner-ear structures. Your ENT will help choose the best plan for you.
Why Early Care Matters
The inner ear is time-sensitive. Delays in diagnosis and treatment lower the odds of regaining normal hearing. If you or someone you love notices sudden hearing loss, new ear fullness, or unexplained ringing in one ear, it’s safest to treat it as urgent—just like vision loss or chest pain.
Sudden hearing loss is an ENT emergency. If you wake up with sudden ear fullness, ringing, or hearing loss, call us right away. Early evaluation and timely steroid treatment, oral or injected, give the best chance to save your hearing.
