Adequate perception of sounds is the most important component of normal human activity. Hearing informs us about changes in the environment, performs as an alarm and warn function, contributes to a normal orientation in space, provides communicative processes – people’s speech communication is almost entirely determined by the perception of sounds. The hearing organ, like other sensory organs, is responsible for stimulating the cortical processes of the brain – thinking, memory, emotional state and creative abilities of a person.
Persistent hearing loss, against which the perception of surrounding sounds and speech communication is difficult and is defined by the term hearing loss. Weakening of the auditory function can be expressed in various degrees: from a slight decrease in hearing to a complete loss of sound perception. Hearing loss may be due to a decrease in the sensitivity of tonal perception of sounds with respect to the age norm through the air (sensory, sensorineural, perceptual hearing loss, cochlear neuritis), through bone (conductive hearing loss), through air and bone simultaneously (mixed hearing loss), as well as a decrease in speech intelligibility with an age-old hearing rate.
Hearing loss is a global, social and medical problem. The significant prevalence of this pathology and its vast impact on all aspects of human life determine the close attention of doctors in a number of specialties to the diagnosis, the selection of adequate treatment and the prevention of various types of hearing loss. At the present stage, approximately 10% of the total population of the planet, that is, about 500 million people, have some kind of hearing problem, 14% of people aged 35 to 65 and 30% over 65 suffer from a hearing impairment. More than 5% of the world’s population – 360 million people (of which 9% are children) suffer from disabling hearing loss – more than 40dB in a better hearing ear in adults, 30dB in childhood. According to statistics from the World Health Organization, up to 4,000 new patients with this pathology are registered annually.
The most complex and significant problem is sudden sensorineural hearing loss, the frequency of such cases, is slightly less than 1% of all hearing impairments. Sudden sensorineural hearing loss is a hearing loss caused by damage to the cochlea, auditory nerve, brain stem or cortical hearing centers. Infectious, immunopathological, physical, chemical and ischemic-hypoxic factors may be the reasons for the development of acute disturbances in sound perception. The name of sudden sensorineural hearing loss is due to the fact that this hearing disorder is generated in less than 72 hours. Hearing capacity is reduced by up to 30%, which may mean that some conversations are heard as if they were whispers.
Sudden sensorineural hearing loss is one of the most striking symptoms of damage to the inner ear or brain region that is responsible for hearing. There are many reasons that cause such damage: a viral or bacterial infection, exposure to toxins, side effects of drugs, circulatory disorders, cerebral arterial thrombosis of various sizes, trauma and others.
This form of hearing loss is usually one-sided. A person suddenly has a noise in one ear, a sensation of numbness of the auricle. If you bring a handset or headphones to your ear, it becomes clear that the difference in the perception of sounds by the left and right ear is significant. People with “sudden deafness” describe the hearing loss as “turning off” or “breaking the telephone wire.” A high degree of hearing loss is characteristic from the first hours of the disease, up to complete deafness. Sometimes hearing loss develops within a few days. But even at the first symptoms it is urgent to seek medical help.
In a number of people, hearing loss is irreversible, 1/3 of people, a few days after the onset of symptoms, an improvement occurs. The projection for hearing restoration is worse, the later treatment begins. For example, thrombosis of the arteries that feed the inner ear, a change in blood viscosity, a viral infection can lead to complete deafness and, in parallel, to impaired vestibular function.
However, the cause of sudden sensorineural hearing loss can be reliably determined only in 10-15% of patients; in all other cases, hearing loss is considered undetermined. With sudden sensorineural hearing loss, vascular disorders are most often detected as the causing factor. Acute sensorineural hearing loss develops over several days and is characterized by an increase in tonal thresholds for tissue sound conduction of varying severity, that is, a decrease in hearing in one or both ears, a violation of speech intelligibility, a distortion in the perception of sounds, and tinnitus. In some people, systemic dizziness and other vestibular disorders are experienced, ototopic disturbances, impairment of noise tolerance, loud harsh sounds and other symptoms may occur. Sudden sensorineural hearing loss is characterized by lightning-fast or within a few hours’ development of the pathological process and a high degree of hearing loss, up to complete deafness. According to various studies, spontaneous recovery occurs only in 32-65% of cases. With timely and appropriate treatment, in most cases, people with sensorineural hearing loss manage to improve or restore their hearing to the previous level.
Diagnosis of sudden sensorineural hearing loss
To confirm the diagnosis of sudden sensorineural hearing loss, the first thing your GP would do is to send you to an Audiologist for a hearing test. An audiologist will perform tonal audiometry, with which it can be confirmed if the hearing loss is of the sensorineural type or not: that is, if the sound does not reach the inner ear, due to , for example, to an obstruction in the ear, or if it does arrive but the ear cannot process the sound that came due to a problem with the auditory nerve , which is somewhat more serious.
Solutions to sudden hearing loss (short-term)
What audiologists would recommend doing in a case of sudden sensorineural hearing loss is to start treatment as soon as possible after diagnosis, even if the causes are unknown. The treatment for people with sudden sensorineural hearing loss, depending on the etiopathogenetic characteristics of the disease, involves the use of nootropic, vasoactive, anti-aggregate, ion and neurotropic, antioxidant, antimicrobial agents, hyperbaric oxygenation, cognitive techniques, plasmapheresis and some other treatment methods. In each specific clinical case, the risks of developing side effects and the appropriateness of prescribing a particular type of therapy are assessed.
Treatment of sudden sensorineural hearing loss with the use of corticosteroid. Since the exact cause of acute hearing loss is not known, standard treatment is not always possible. After a sudden loss of hearing, one is first tried to reduce risk factors, especially to improve blood circulation in the ear. The most common and proven treatment in this case is the use of rheological agents to promote fluids. These improve blood circulation, which is responsible among other things for the transport of nutrients inside and outside the inner ear. Rheological perfusions are used to better irrigate the sensory cilia in the inner ear. In addition, anti-inflammatory agents are often used. This treatment is intended to prevent possible inflammation in the ear, that could harm your hearing. As a rule, corticosteroids are used; they are administered either by infusion or in the form of tablets. It is not uncommon for such a preparation to be used to directly irrigate the middle ear. For this purpose, your GP may pierce the tympanic membrane and inject cortisone with a syringe in the middle ear, where it also flows into the inner ear.
Normally that includes the administration of systemic corticosteroids orally and sometimes intratympanic corticosteroids, by injections, to reduce inflammation in the ear.
Treatment of sudden sensorineural hearing loss with B vitamins. In the treatment of patients with sudden sensorineural hearing loss, in order to minimize the damaging effect of causal factors in the development of the pathological process, improve metabolic processes, restore functional activity and tissue regeneration, including neuroepithelium, the use of B vitamins is indicated. Thiamine (vitamin B1) has antioxidant activity and plays an important role in carbohydrate metabolism, energy processes in the cells of the nervous system, helps restore its damaged structures, modulates neuromuscular transmission. Pyridoxine (vitamin B6) is also an anti-oxidant, participates in protein metabolism, the synthesis of many biologically active substances and nerve fiber membranes, and regulates the intracellular content of magnesium ions, provides adequate transmission of impulses in synapses, is a coenzyme for many enzymes. Cyanocobalamin (vitamin B12) normalizes the processes of cell division, myelination of nerve fibers, lipid and protein metabolism, and has a homopoietic, erythropoietic, antianemic, metabolic effect. For therapeutic purposes, vitamin preparations are prescribed in higher doses than with hypo- and vitamin deficiencies. The separate use of B vitamins in clinical practice leads to poly-pragmasia, reduces compliance, in addition, the combination of these 3 vitamins has a better effect on the functions of the nervous system than the appointment of individual components, and therefore the use of combined dosage forms is most effective.
Solutions to sudden hearing loss (long-term)
When sudden hearing loss continues, damage occurs to the sensory hair cells in the inner ear, which cannot be resolved spontaneously. The hearing is then permanently damaged and cannot be cured. The sensorineural hearing loss can be compensated with a hearing aid, at least partially. A modern hearing aid is able to make the frequencies lost by the affected person again perceptible to the ear. It not only amplifies the sound signals, but also masks hearing problems. Hearing aids can also be helpful when sudden loss of hearing occurs with tinnitus. Some of the lost hearing capacity can be restored and the quality of life of the affected patients increases significantly. Looking for a long term solution to your sudden sensorineural hearing loss? Contact one of our Attune clinics today to discuss options with one of our qualified Audiologists.