How Is Sshl Diagnosed
Timely diagnosis is critical because the window for treating SSHL with steroids is only 4 weeks from onset. It is critical to determine that any sudden hearing loss is indeed sensorineural .
A hearing test known as an audiogram can differentiate between sensorineural and other types of hearing losses. Sudden hearing loss can also occur from ear wax, congestion from a cold or allergies, or water in the ear. Eustachian tube problems can produce hearing loss similar to that experienced during ascent/descent on an airplane. These causes of hearing loss are termed conductive hearing loss. Unfortunately, patients often experience delays in diagnosis because healthcare providers mistake SSHL for ear wax or congestion from colds and allergies. A hearing test can easily help differentiate between different types of hearing loss.
It is imperative that patients be evaluated by an ENT physician. An ENT will closely inspect the ear canal and eardrum with a microscope. They will also perform a neurologic and vestibular evaluation. A hearing test will evaluate the different parts of the ear.
A brain MRI will examine for neurological problems that can cause SSHL. These problems can include tumors, multiple sclerosis, or stroke.
About Sensorineural Hearing Loss
Your ear is made up of three partsthe outer, the middle, and the inner ear. Sensorineural hearing loss, or SNHL, happens after inner ear damage. Problems with the nerve pathways from your inner ear to your brain can also cause SNHL. Soft sounds may be hard to hear. Even louder sounds may be unclear or may sound muffled.
This is the most common type of permanent hearing loss. Most of the time, medicine or surgery cannot fix SNHL. Hearing aids may help you hear.
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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Help And Support For Sudden Sensorineural Hearing Loss
Recovery from SSHL can be a distressing time and it is important to get as much support as you can. On a day to day basis coping with hearing loss can be daunting and leave you feeling very tired as you have to concentrate so much harder to understand what is being said and navigate the world around you.
In the immediate short term please get in touch with Hearing Link:
- Contact our friendly Helpdesk for personal advice and support.
- We can put you in touch with a specially trained volunteer who will understand what you are going through.
- Consider attending one of our free courses which run throughout the year in different places all over the UK.
- Go online to visit some useful social network forums.
- Find out about safety and assistive devices, including flashing doorbells, smoke alarms, streamers and TV loops.
What To Expect At Your Office Visit
The goal of treatment is to improve your hearing. The following may be helpful:
- Telephone amplifiers and other assistive devices
- Safety and alert systems for your home
- Sign language
- Speech reading
A cochlear implant may be recommended for certain people with severe hearing loss. Surgery is done to place the implant. The implant makes sounds seem louder, but does not restore normal hearing.
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Hearing Aids And Cochlear Implants
If your hearing care professional recommends hearing aids, they will work with you to calibrate them to your specific hearing loss, during a process known as fitting. Hearing aids do not cure or restore hearing. The basic purpose of a hearing aid is to amplify sound. But today’s hearing aids can be highly customized to your specific hearing needsamplifying the sounds you need to hear while minimizing those you don’t. While they can’t exactly mimic normal hearing, they work very well for people with mild to moderate hearing loss.
Hearing aids can be worn behind the ear or in the ear depending on the degree of hearing loss and personal preference. There are many types and styles. And yes, if you have hearing loss in both ears, two hearing aids are far better than one.
For some people, cochlear implants will be the recommend treatment. Implants require surgery, but they can be an excellent option for people who aren’t helped enough by hearing aids, including older adults.
How To Get Help
If you or a loved one has a hearing loss, visit our directory of consumer-reviewed hearing clinics to find a professional right away. He or she will investigate the cause and suggest treatment options to suit your needs. Many conductive and mixed hearing losses can be treated medically and nearly all types of hearing loss is treatable with hearing aids, implantable devices and/or assistive listening devices.
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Differential Diagnosis And Treatment Of Hearing Loss
JON E. ISAACSON, M.D., and NEIL M. VORA, M.D., Milton S. Hershey Medical Center, Hershey, Pennsylvania
Am Fam Physician. 2003 Sep 15 68:1125-1132.
Hearing loss is a common problem that can occur at any age and makes verbal communication difficult. The ear is divided anatomically into three sections , and pathology contributing to hearing loss may strike one or more sections. Hearing loss can be categorized as conductive, sensorineural, or both. Leading causes of conductive hearing loss include cerumen impaction, otitis media, and otosclerosis. Leading causes of sensorineural hearing loss include inherited disorders, noise exposure, and presbycusis. An understanding of the indications for medical management, surgical treatment, and amplification can help the family physician provide more effective care for these patients.
More than 28 million Americans have some degree of hearing impairment. The differential diagnosis of hearing loss can be simplified by considering the three major categories of loss. Conductive hearing loss occurs when sound conduction is impeded through the external ear, the middle ear, or both. Sensorineural hearing loss occurs when there is a problem within the cochlea or the neural pathway to the auditory cortex. Mixed hearing loss is concomitant conductive and sensorineural loss.
How Do You Know If You Have Sensorineural Hearing Loss
You may have a sensorineural hearing loss if you experience any of these , but the only way to know for sure is to get a hearing test.
The main purpose of the hearing test, aside from measuring your overall hearing ability, is to determine the type of hearing loss you have.
In order to do that, your hearing care provider is going to administer a few tests, which essentially aim to determine as to where in the the problem is occurring.
Your hearing care provider will want to find out if the problem exists somewhere in the ear canal or middle ear, in conducting the sound to your inner ear, or if the problem exists in the cochlea or auditory nerve, sending that signal to your brain.
The way we isolate where the breakdown is occurring, is by performing two types of hearing tests: air conduction testing and bone conduction testing.
Air conduction testing is the test where your hearing care professional places a set of headphones over or in your ears. You have to raise your hand or press a button when you hear a beep. The beeps have to travel through your entire ear down your ear canal, through the eardrum and the ossicles, and through the cochlea and the nerve for you to hear them. When most people think of getting a hearing test, this is what they think of, and its the kind that almost all of us are given periodically in elementary school.
If youre following along, you can probably see why bone conduction testing is necessary, and what it tells us.
Is Sensorineural Hearing Loss Permanent
Yes, unfortunately a sensorineural hearing loss is permanent as the hair cell in the inner ear cannot be repaired or replaced. And regardless of whether it is a bilateral or unilateral hearing loss the hearing does not recover fully or partly over time or by itself. The hearing that is lost is lost permanently. An age-related hearing loss, for example, typically worsens over time.
Can a sensorineural hearing loss be cured? In most cases unfortunately not. A sensorineural hearing loss is normally treated with hearing aids or hearing implants. Certain types of sudden sensorineural hearing losses can in some cases be cured but here it is important to seek medical help immediately.
Factors That Can Lead To Sensorineural Hearing Loss
- Aging is one of the most common factor progressive sensorineural hearing loss
- Some Sensorineural hearing loss causes due to advanced age and typically occurs in both ears.
- Ototoxic medications, such as those used to treat heart disease and cancer, can also result in SNHL.
- Genetics diseases infection, trauma, and prolonged noise exposure are other possible causes of SNHL.
- The sensorineural hearing loss may also occur due to some diseases such as mumps, meningitis, multiple sclerosis, ménières disease.
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Sudden Sensorineural Hearing Loss Treatment
The recommended treatment for SSHL is a course of high dose steroids . Access to treatment very quickly after the onset of SSHL is crucial to improving the chances of restoring your hearing, ideally within 48 hours or less. You should at this point be referred to the care of an ENT specialist.
Once on steroid medication, recovery can take a few weeks or longer and may require a repeat course of steroids. Seek advice from ENT for all options available to you.
Testing & Treating Sensorineural Hearing Loss
An audiologist will perform several types of hearing tests to determine if a patient has a sensorineural hearing loss and the severity of it. For children too young to cooperate with testing, medical staff will provide a sedative. This helps the child fall asleep, before various sounds are played into the childs ear via a small tube. The response from the tiny hairs of the inner ear then determine whether the child has normal hearing or not.
Most individuals with sensorineural hearing loss are classified as having mild-to-moderate hearing loss and will benefit from wearing hearing enhancement devices. However, the majority of individuals in the mild-to-moderate stages decline to purchase hearing aids. Traditionally, these individuals decline to treat their hearing for one or more of the following reasons:
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Conductive Vs Sensorineural Hearing Loss
When something is blocking the transmission of sound waves from reaching the inner ear, conductive hearing loss is occuring. Some examples of conductive hearing loss include:
- Excessive ear wax in the ear canal
- Fluid from ear infections or bones stiffening in the middle ear
“Conductive hearing loss can often be treated successfully medically or surgically,” says Shoup. “If hearing persists, amplification may be an option. Sensorineural hearing loss is caused by damage or loss of the sensory cells of hearing, the hair cells, or changes in the hearing nerve or brain networks that process sounds. Sensorineural hearing loss is typically treated with amplification devices, such as custom fit hearing aids.”
What Is Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss is hearing loss that damages the inner ear . SSHL most frequently happens in one ear. Patients often wake up with the sound of an ear that sounds blocked, congested, or clogged ear. They may also have other symptoms such as ringing in the ears or tinnitus. About half of patients may experience spinning dizziness called vertigo. Together, these symptoms indicate that the inner ear that provides sensations for hearing and balance are being damaged.
SSHL is an emergency of the ear. Early treatment within 2 weeks can recover hearing in 80% of cases.
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Can Sensorineural Hearing Loss Get Worse
Yes, a sensorineural hearing loss can get worse. Some types of sensorineural hearing loss develop over time such as an age-related hearing loss, where people typically lose more and more of their hearing ability over time. Other types of sensorineural hearing loss are more stable. It always depends on the cause of the hearing loss. If you experience your hearing loss getting worse, it is important to get your hearing tested and get your hearing aids adjusted to the actual hearing level.
Sensorineural Hearing Loss Prognosis
The outlook for people with SNHL is highly variable depending on the extent and cause of hearing loss. SNHL is the most common type of permanent hearing loss.
In cases of sudden SSHL, the Hearing Loss Association of America says that 85 percent of people will experience at least a partial recovery if theyre treated by an ear, nose, and throat doctor. About of people regain their hearing spontaneously within 2 weeks.
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Syndromic Sensorineural Hearing Loss Treatment & Management
- Author: Stephanie A Moody Antonio, MD Chief Editor: Arlen D Meyers, MD, MBA
Medical therapy: Treat any middle ear disease, including otitis media, with the appropriate medical therapy.
The goal of amplification is to use any residual hearing to at least orient patients to surrounding environments. Hearing amplification can generally be implemented successfully during the first 6 weeks of life.
Available hearing amplification devices include conventional analog hearing aids, digital hearing aids, bone conduction hearing aids, and bone-anchored hearing aids. Other middle and inner ear implantable devices are undergoing clinical trials.
Assistive listening devices and personal systems
Personal devices, such as FM trainers, aid in reducing the signal-to-noise ratio in various listening situations with significant background noise, eg, classrooms.
Telephone devices can include such items as volume controls and couplers for use with certain hearing aids, along with telecommunication devices for deaf persons who are unable to use standard telephones.
Closed captioning allows television use for individuals who are severely hearing impaired.
Signaling devices substitute visual signals for auditory signals. They can detect environmental sounds, such as doorbells, telephones, alarm clocks, fire alarms, or crying babies.
Sudden Sensorineural Hearing Loss
While SNHL is typically gradual, there is a variation of SNHL that can result in sudden deafness: sudden sensorineural hearing loss . With SSHL, there is rapid, unexplained loss of hearing. It can occur all at once or over several days. SSHL may affect only one ear. Health care professionals consider SSHL to be a medical emergency.
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Treatment For Sensorineural Hearing Loss
It’s important to detect hearing loss as soon as possible. âWhen a person is diagnosed with sensorineural hearing loss, the severity will greatly impact the treatment options available,â Lilach Saperstein, AuD, an audiologist and host of the All About Audiology podcast tells WebMD Connect to Care.
According to Saperstein, sensorineural hearing loss is not curable, but there are ways to make sounds more audible. âHearing aids and cochlear implants are among the common devices,â Saperstein says. Another recommendation by Saperstein is the introduction of sign language as a means to communicate. This is especially important considering that your hearing could worsen as you age.
Hearing Aids: Hearing aids are one of the options to consider in the treatment of hearing loss. They are small devices you wear inside or behind your ear. Whether you experience slight or profound SNHL, hearing aids are a good first option. Hearing aids make the sounds in your environment louder and help you become more aware of your surroundings. They can also help with understanding speech.
How Hearing Works Explained In 5 Simple Steps
The key to sensorineural hearing loss lies in step 5, with those those hair cells in the cochlea.
When the ear bones vibrate the fluid in the cochlea, its like dropping a rock at one end of a pond.
Waves travel up and down the fluid in the cochlea, like the waves would spread in the water in the pond when you drop a rock at one end.
In the cochleas fluid, there are structures called hair cells.
The hair cells are not, despite the name, actually strands of hair. They are just called that because part of the cell structure is long and thin and bends when waves travel through the fluid.
The hair cells move when the fluid vibrates, and the hair cell movement sends signals to your brain via the auditory nerve.
Check out the cool picture of hair cells in the cochlea, below.
They have those white strands that you see sticking up. These strands will bend when waves travel through the fluid.
Hair cells in the cochlea. Image credit: Wikimedia commons
Your brain interprets the signals that it gets from the auditory nerve.
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