What Are The Treatment Options
If you are experiencing hearing loss, you should see an ENT specialist who can make the correct diagnosis. This is important because the treatment for hearing loss depends on the cause. Once a diagnosis is made, your physician will be able to talk to you about all treatment options. A critical part of the evaluation will be a hearing test performed by an audiologist to determine the severity of your hearing loss, as well as whether it is conductive, sensorineural, or a combination of both.
Your ENT specialist may recommend specific treatment options based on the results of your hearing test, or other potential tests such as a CT or MRI imaging scan. Treatment options can include:
- Continuing observation with repeated hearing tests
- Medical therapycorticosteroids may be used to reduce cochlear hair cell swelling and inflammation after exposure to loud noises diuretics may be used for Ménières disease
- Low-sodium diet
- Evaluation and fitting of a hearing aid or other assistive listening devices
- Preferential seating in class for school children
- Surgery to correct the cause of the hearing loss
- Surgery to implant a hearing device
SNHL can be treated with the use of conventional hearing aids or an implantable hearing device. Again, your ENT specialist and/or audiologist can help you decide which device may work best for you depending on your hearing test results and your lifestyle.
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Association Of Multiple Sclerosis And Sudden Sensorineural Hearing Loss
- Medicine
- Multiple sclerosis journal – experimental, translational and clinical
- European review for medical and pharmacological sciences
- 2018
- Multiple sclerosis and related disorders
- 2019
- Irish Journal of Medical Science
- 2021
- View 2 excerpts, cites background
- International journal of pediatric otorhinolaryngology
- 2020
How Is Sudden Deafness Treated
The most common treatment for sudden deafness, especially when the cause is unknown, is corticosteroids. Steroids can treat many disorders and usually work by reducing inflammation, decreasing swelling, and helping the body fight illness. Previously, steroids were given in pill form. In 2011, a clinical trial supported by the NIDCD showed that intratympanic injection of steroids was as effective as oral steroids. After this study, doctors started prescribing direct intratympanic injection of steroids into the middle ear the medication then flows into the inner ear. The injections can be performed in the offices of many otolaryngologists, and are a good option for people who cannot take oral steroids or want to avoid their side effects.
Steroids should be used as soon as possible for the best effect and may even be recommended before all test results come back. Treatment that is delayed for more than two to four weeks is less likely to reverse or reduce permanent hearing loss.
Additional treatments may be needed if your doctor discovers an underlying cause of your SSHL. For example, if SSHL is caused by an infection, the doctor may prescribe antibiotics. If you took drugs that were toxic to the ear, you may be advised to switch to another drug. If an autoimmune condition caused your immune system to attack the inner ear, the doctor may prescribe drugs that suppress the immune system.
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Diagnosing Hearing Loss With Ms
It is important to note that MS may not necessarily be the cause of hearing loss. As one MyMSTeam member shared, About three years ago, my hearing in my right ear was very muffled, and I had a lot of ringing. I was sent for hearing tests and an MRI, and it wasnt to do with the MS I was diagnosed with Ménières disease. It is important to see a health care professional for diagnosis as soon as you notice any changes in your hearing to rule out the possibility of another condition.
In most cases, an audiologist a health care provider specializing in the evaluation, diagnosis, and treatment of hearing problems and balance disorders will be the one to make this determination. They will be able to determine whether MS or another condition or illness, such as an ear infection, may be causing changes in your hearing.
Webers And Rinnes Tests
Webers test and Rinnes test are used to differentiate between sensorineural and conductive hearing loss. A tuning fork is used to perform both tests.
Webers Test
To perform Webers test:
- Strike the tuning fork to make it vibrate and hum
- Place it in the centre of the patients forehead
- Ask the patient if they can hear the sound and which ear it is loudest in
A normal result is when the patient hears the sound equally in both ears.
In sensorineural hearing loss, the sound will be louder in the normal ear . The normal ear is better at sensing the sound.
In conductive hearing loss, the sound will be louder in the affected ear. This is because the affected ear turns up the volume and becomes more sensitive, as sound has not been reaching that side as well due to the conduction problem. When the tuning forks vibration is transmitted directly to the cochlea, rather than having to be conducted, the increased sensitivity makes it sound louder in the affected ear.
TOM TIP: The way I remember which way round these tests are, is to picture Spiderman shooting a web right in the middle of someones face.
To perform Rinnes test:
A normal result is when the patient can hear the sound again when bone conduction ceases and the tuning fork is moved next to the ear rather than on the mastoid process. It is normal for air conduction to be better than bone conduction. This is referred to as Rinnes positive.
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How Does Ms Lead To Hearing Loss
Hearing loss in MS is rare, affecting only about 6 percent of people with the condition. Even more rarely, hearing loss may be the first symptom of multiple sclerosis. Hearing loss may affect people with early or long-standing MS.
It is believed that MS-related hearing loss can result from damage to the nerve pathways in the brain and brain stem. Multiple sclerosis causes lesions, or areas of damage and scarring , to form along the central nervous system. MS lesions on the brain stem, auditory nerve, or other sites can disrupt the auditory pathway, potentially leading to hearing loss.
Sensorineural hearing loss refers to hearing loss caused by damage to the auditory nerve or the structures of the inner ear. Although it is not a common MS symptom, this type of hearing loss is far more common in people with multiple sclerosis than in the general population. Sudden sensorineural hearing loss , in particular, develops over several hours to three days. In 4 percent to 10 percent of people with MS, this type of hearing loss occurs between relapses or remissions . As one MyMSTeam member wrote about their hearing loss, I’ve experienced it since my flare-up last March.
What Causes Hearing Problems
Hearing problems caused by MS are thought to be due to damage to the brainstem – the part of the brain that is also involved in visionand balance. Problems are often associated with other brainstem symptoms such as tinnitus and vertigo.
Sudden hearing problems can show that you are having a relapse. Treatment with steroids may speed up recovery of hearing. Hearing problems may also be linked to sensitivity to heat. If this is the case, your hearing may get worse when your body temperature rises and then return to normal when you cool down.
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Auditory Neuropathy Spectrum Disorder
Auditory neuropathy spectrum disorder is a hearing disorder in which sound enters the inner ear normally but the transmission of signals from the inner ear to the brain is impaired. It can affect people of all ages, from infancy through adulthood. The number of people affected by auditory neuropathy is not known, but the condition affects a relatively small percentage of people who have hearing loss.
People with ANSD may detect sound at normal levels, or have a hearing loss ranging from mild to severe. What makes this hearing disorder challenging is the individuals have trouble understanding speech clearly, despite having the ability to detect it. In other words, speech perception ability is worse than would be predicted by the degree of hearing loss. For example, a person with ANSD may be able to hear sounds, but would still have difficulty recognizing spoken words.
Outer hair cells help amplify sound vibrations entering the inner ear from the middle ear. When hearing is working normally, the inner hair cells convert these vibrations into electrical signals that travel as nerve impulses to the brain, where the impulses are interpreted as sound.
Types Of Sensorineural Hearing Loss
Sensorineural hearing loss may affect one ear or both ears depending on the cause.
- Bilateral sensorineural hearing loss. Genetics, exposure to loud sounds, and diseases like measles can lead to SNHL in both ears.
- Unilateral sensorineural hearing loss. SNHL might only affect one ear if its caused by a tumor, Menieres disease, or a sudden loud noise in one ear.
- Asymmetrical sensorineural hearing loss. Asymmetrical SNHL occurs when theres hearing loss on both sides but one side is worse than the other.
Doctors use several types of tests to properly diagnose sensorineural hearing loss.
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Canadian Academy Of Audiology
Presbycusis is the loss of hearing that gradually occurs in most individuals as they growolder. Hearing loss is a common disorder associated with aging. About 30-35 percentof adults between the ages of 65 and 75 years have a hearing loss. It is estimated that40-50 percent of people 75 and older have a hearing loss. The loss associated withpresbycusis is usually greater for high-pitched sounds. For example, it may be difficultfor someone to hear the nearby chirping of a bird or the ringing of a telephone. However,the same person may be able to clearly hear the low-pitched sound of a truck rumblingdown the street.
There are many causes of presbycusis. Most commonly, it arises from changes in theinner ear of a person as he or she ages, but presbycusis can also result from complexchanges along the nerve pathways leading to the brain. Presbycusis most often occursin both ears, affecting them equally. Because the process of loss is gradual, people whohave presbycusis may not realize that their hearing is diminishing.
Can Ms Cause Hearing Problems
MS is not completely predictable. The course of the disease can vary greatly from one person to the next and can lead to a wide range of symptoms in different people. MS affecting different areas of the CNS may result in the specific symptoms in each case.
Hearing problems are an uncommon but possible complication of MS, occurring in roughly 6% of people with MS. They may result from damage to the hearing nerve pathways present in the brain and brainstem.
Hearing difficulties may occur as part of an exacerbation of the condition. This refers to when old symptoms get worse or new ones develop. Hearing problems can be a short-term symptom in some cases, but some people may experience longer lasting changes to their hearing.
Sensorineural hearing loss is a type of hearing loss that can occur after damage to the nerve pathways of the inner ear. While hearing loss is not a common symptom of MS, evidence notes that SNHL in the MS population far exceeds that in the general population.
It can make softer sounds hard to hear and may cause louder sounds to be unclear or sound muffled. This may make it difficult for a person to understand words against background noises.
SNHL may follow a progressive or fluctuating pattern in people with MS. A 2018 systematic review notes that it is more common in the early stages of the disease and may come on suddenly. But it may also occur progressively as the disease itself progresses.
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What To Do If You Experience Hearing Loss
MS hearing loss is rare. If you experience hearing problems you need to see a doctor in case they need to refer you to an ear, nose and throat specialist, to investigate the cause of your hearing loss. There are many other reasons why you might be experiencing hearing loss, such as medications, injury from a loud noise, other illnesses not related to MS or even ear wax build-up.
If your hearing loss is part of an MS relapse, then it will often return to normal or improve as the inflammation around the affected nerves reduces. A doctor can prescribe steroids to try to speed up the improvement. By following the OMS Program you can also help to improve other MS symptoms through diet and lifestyle changes. One of the steps within the program is exercise which can help strengthen your muscles, including your core, to help with balance problems.
If your hearing loss is long-term, an audiologist may be able to recommend a hearing aid. Sometimes public places can be fitted with induction or hearing hoops which work with your hearing aid to reduce background sounds and noise. These loops can also be installed in your home if needed.
Sudden Hearing Loss: A Peril In Multiple Sclerosis
Sudden hearing loss is a rare but real potential complication in multiple sclerosis.
Sudden sensorineural hearing loss is a rare symptom of multiple sclerosis , however people with MS experience SSHL far more often than the general population, according to the findings of a recent study.
in the Multiple Sclerosis Journal — Experimental, Translational and Clinical, the study was conducted by Sari Atula of the Department of Clinical Sciences, Neurology, at the University of Helsinki and Helsinki University Hospital in Finland, and colleagues.
The researchers describe their objective, saying, We aimed to assess the incidence of SSHL among MS patients, its frequency as an initial symptom of MS, and magnetic resonance imaging findings associated with SSHL in MS. In order to complete that assessment, they examined patient records from an 11-year period.
The researchers found a total of 2736 patient records for patients diagnosed with MS or demyelinating disease from the Helsinki University Hospital. During the same period, 1,581 patients were treated for SSHL. The researchers report, Of the 18 patients with both diagnoses, 17 patients were diagnosed with MS, and on patients with neuromyelitis optica with features of MS. However, they say, MS was present in 1.1% of all SSHL cases.
In conclusion, this study shows that MS associates with SSHL, but that SSHL is rarely an initial symptom of MS, say the authors.
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What Is Sensorineural Hearing Loss
Sensorineural hearing loss, one of the most common hearing complaints, can be caused by a number of factors including age, damage to the ear, loud noise and disease or ear infection. Also called nerve deafness, it is the most common form of hearing loss amongst the elderly . At its root however, sensorineural hearing loss is an inner ear or auditory nerve dysfunction or impairment.
Autoimmune Inner Ear Disease
Barbara “Barbie” Bell-Lehmkuhler
Brian McCabe, MD, first described autoimmune sensorineural hearing loss in his landmark 1979 paper. McCabe described a series of 18 patients whose “clinical pattern did not fit with known entities and thus seemed to merit distinctive categorization.” Since that time, autoimmune inner ear disease or immune-mediated sensorineural hearing loss, has taken its place as a cause of sensorineural hearing loss and vestibular symptoms.
AIED occurs when the body’s immune system attacks cells in the inner ear that are mistaken for a virus or bacteria. AIED is a rare disease occuring in less than 1% of the 28 million Americans with a hearing loss. It can happen in isolation or as part of other systemic autoimmune disorders. Twenty percent of patients have other autoimmune diseases, such as rheumatoid arthritis or lupus.
Because of the difficulty in the differential diagnosis of AIED, many have proposed the use of lab tests to assist in the medical diagnosis. McCabe originally recommended an “immune screen” to include
- Erythrocyte sedimentation rate, which is a general indicator of inflammation
- Rheumatoid factor, which is a marker for rheumatoid arthritis and other autoimmune diseases
- Anti-nuclear antibody titer, to check for lupus and other autoimmune diseases
- quantitative immunoglobulin determination and
- A leukocyte migration inhibition test.
Later, Campbell and Klemens listed other medical tests they commonly use to detect AIED:
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How Does It Affect How You Hear
Sensorineural hearing loss affects both the loudness and the clarity of the sounds you hear. You may also experience a reduced range of sounds you find comfortable. Meaning, soft and normal sounds are too soft, but loud sounds very quickly get too loud and may really bother you.
Sensorineural hearing loss can affect all ranges of hearing. For people with age-related hearing loss, however, it’s typical to experience what’s known as high-frequency hearing loss, which results in the reduced ability to hear high-pitched sounds.
Many people with sensorineural hearing loss report that they can hear but struggle to understand speech. This is especially true in the presence of background noise, and it can be frustrating and exhausting to deal with.
Sensorineural Hearing Loss In Babies
Did you know that sensorineural hearing loss can also occur in babies? One of the most common causes of sensorineural hearing loss in babies is genetics. Passing it from a parent to a child at conception is more common than you may think. Studies show that 1-3 babies, out of 1000 births, are diagnosed with sensorineural hearing loss due to the genes of at least one of their parents. Thankfully, with the assistance of modern medicine and improved technology, successful treatment prevents potential speech and communication barriers when sensorineural hearing loss happens through genetics. If your child or loved one’s child is affected by this type of hearing loss, explore your treatment options early.
While it is not uncommon for genetics to cause sensorineural hearing loss in newborns, it is not the only cause. Other causes of sensorineural hearing loss in babies include, but is not limited to:
- A premature birth
- Maternal diabetes
- Lack of oxygen at birth
Additionally, sensorineural hearing loss may also occur in babies due to infections and fever at birth.
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