Sudden hearing loss usually affects one ear, but can affect both ears. Like other forms of hearing loss, we divide it up into ‘conductive’ and ‘sensorineural’ forms. See more here. 


Sudden conductive hearing loss is usually due to wax completely occluding the ear canal, or fluid filling up the middle ear. Wax can be easily removed. Fluid will usually go away on its own, although if it doesn’t, then medications or minor procedures can remove the fluid. When there is fluid in one ear but not the other, additional tests are required. Conductive hearing loss is almost always something that can be made better with treatment. See more here. 


Sudden sensorineural hearing loss tends to be more concerning. This is because while sudden sensorineural loss can get better on its own, it frequently doesn’t, and leaves a permanent hearing loss (often accompanied by tinnitus). While hearing aids can help, they are not the same as having normal hearing. We don’t know what causes sudden sensorineural hearing loss as the hearing organ is too small for non-invasive tests to tell us very much about problems with its workings, and invasive tests would make hearing loss worse. We think it is often to do with the body’s immune system attacking the hearing organ. 


We know that steroid medications, given as soon as possible after the hearing is lost, are the best way to maximise the chances of the hearing getting better. This has been shown by a number of studies (1). Steroids can be taken by mouth or injected into the ear. Injecting into the ear involves going to hospital, and the procedure can be uncomfortable, but it is the most effective way of giving treatment with the fewest side effects. Complications with these injections are very rare (2). Oral steroid medications are an alternative, but they can interfere with sleep, and have other small risks.


After a sudden sensorineural hearing loss, it is advisable to monitor the hearing closely to look for worsening or improvement. It is not uncommon for treatments such as steroid injections to need to be repeated. 



References:

1. Intratympanic methylprednisolone administration promotes the recovery of idiopathic sudden sensorineural hearing loss: a retrospective case-control study. Jiang K, Li S, Cheng L, Yang J. Acta Otolaryngol. 2018 Nov;138(11):998-1003.

2. A Case of Incus Necrosis Following Oral and Intratympanic Steroid Administration for Sensorineural Hearing Loss. Kapoor E, Sabetrasekh P, Monfared A. Otol Neurotol. 2020 Oct;41(9):1210-1213.