Sudden Hearing Loss in One or Both Ears: What to Do Now

Sometimes the cause is relatively straightforward, such as earwax, fluid, or an ear infection. But sudden loss of hearing can also be sudden sensorineural hearing loss (SSNHL), which affects the inner ear or hearing nerve. Early diagnosis and treatment may improve the chance of recovery, so getting your hearing checked quickly matters.

This article explains what to do if you suddenly lose hearing, what symptoms to look for, possible causes, how sudden hearing loss is diagnosed and treated, and what options may be available if hearing does not fully return.

Is Sudden Hearing Loss in One Ear an Emergency?

Yes. Sudden hearing loss in one or both ears should be treated as a medical emergency until a healthcare professional evaluates it.

One reason is the possibility of sudden sensorineural hearing loss. This type of hearing loss can become permanent, and delayed treatment may reduce efficacy.

This does not mean that every episode of sudden hearing loss will be severe or permanent. Some cases have other causes, including earwax, fluid, or infection. However, you cannot reliably determine the cause from your symptoms alone. That is why prompt professional evaluation is important.

When Should You Seek Emergency Help?

Sudden hearing loss on its own warrants prompt medical attention, and some accompanying symptoms make emergency assessment particularly important.

Seek immediate emergency care if sudden hearing loss occurs with signs such as:

• Facial weakness
• Difficulty speaking
• Physical weakness or numbness
• Severe, sudden headache

Urgent assessment is also important if the hearing loss follows a head injury or is accompanied by:

• Severe dizziness or vertigo
• Severe ear pain
• Drainage
• Fever
• Sudden hearing loss in both ears

What Does Sudden Hearing Loss Feel Like?

Sudden hearing loss does not always mean that all sound disappears instantly. It can feel different from person to person.

You might notice:

• Muffled sounds or sounds that seem more distant than they should
• Suddenly needing to switch ears when using the phone
• Waking up and realizing you cannot hear properly from one ear
• Tinnitus (ringing or buzzing in the ear)
• A feeling of fullness or pressure in the affected ear
• Dizziness or vertigo
• A popping sensation around the time the hearing changes

Some people describe it as though their ear is blocked. That sensation can make it tempting to assume that earwax or congestion is responsible. But similar symptoms can occur with inner ear hearing loss, which is why an examination and hearing test are important.

What Is Sudden Sensorineural Hearing Loss?

Sudden sensorineural hearing loss (SSNHL) is a rapid loss of hearing caused by a problem involving the inner ear or hearing nerve. It usually affects one ear and can happen suddenly or develop within 72 hours.

SSNHL may be accompanied by tinnitus, pressure or fullness in the ear, dizziness or vertigo, or a popping sensation. Some people first notice the problem when they wake up or try to use the affected ear to hear a phone call.

In many cases, a clear underlying cause cannot be identified. This uncertainty is another reason professional assessment is important.

What Can Cause Sudden Hearing Loss in One or Both Ears?

There are many possible causes of sudden hearing loss, ranging from problems that block sound from reaching the inner ear to conditions affecting the inner ear or hearing nerve.

Conductive causes can include earwax blocking the ear canal, fluid or congestion, an outer or middle ear infection, pressure changes, or problems involving the eardrum. These conditions interfere with the transmission of sound.

Sensorineural and other medical causes can include sudden sensorineural hearing loss, inflammatory or viral processes, reduced blood flow, autoimmune diseases, certain ototoxic medications, Ménière’s disease, multiple sclerosis, head trauma, and conditions affecting the hearing nerve.

An acoustic neuroma, for example, is a rare tumor involving the nerve associated with hearing and balance. It is one reason an ENT specialist may recommend an MRI to exclude acoustic neuroma or other retrocochlear pathology when single-sided sensorineural hearing loss has been confirmed.

How Is Sudden Hearing Loss Diagnosed?

The first step is usually an examination of your ears. A healthcare professional can look inside the ear canal for visible causes such as earwax, fluid, infection, or problems with the eardrum.

A hearing test, typically including pure-tone audiometry, is particularly important. During this test, the softest sounds you can hear at different pitches are measured. The resulting audiogram helps show both the degree and type of hearing loss.

Depending on the results, your symptoms, and your medical history, an ENT specialist may recommend additional testing. This can include an MRI, balance tests, or blood tests.

The goal is to determine whether the hearing loss is conductive, sensorineural, or related to another condition so that appropriate treatment can be considered.

Can Sudden Deafness in One Ear Be Treated?

There is no single treatment that works for every cause of sudden hearing loss.

Some symptoms can improve when the underlying problem is treated. For example, management of earwax, infection, fluid, or a pressure-related problem may enable hearing to return, depending on the diagnosis.

For sudden sensorineural hearing loss, corticosteroids are commonly used to reduce inflammation. Depending on the individual case, they may be given orally or by injection through the eardrum.

Timing matters. in many countries recommend clinicians to offer corticosteroids within the first two weeks after the onset of SSNHL. For people whose hearing recovery is incomplete, intratympanic steroid treatment may be offered as salvage therapy two to six weeks after symptoms began.

Treatment becomes less likely to reverse or reduce permanent hearing loss as more time passes. This is why sudden deafness should not be treated as something to wait out at home.

Recovery varies considerably, and no treatment can guarantee that hearing will return.

What If Hearing Does Not Fully Return?

Follow-up hearing tests can show whether your hearing is recovering and help your hearing care team determine the next steps.

Long-term hearing loss in one ear can affect much more than the perceived loudness of sound. Some people have difficulty understanding speech in noisy environments or identifying where sounds are coming from. Hearing loss in one ear also increases listening effort, which can be tiring. And if the hearing loss is accompanied by tinnitus, this can also have a negative impact on daily life.

Depending on the type and severity of hearing loss, hearing specialists may discuss options such as:

• Hearing aids
• CROS-style hearing systems
• Bone conduction hearing options
• Cochlear implants

For people with single-sided deafness (severe-to-profound sensorineural hearing loss in one ear), a cochlear implant may be an option. Unlike technologies that route sound from the poorer-hearing side to the better-hearing ear, a cochlear implant provides stimulation to the auditory pathway on the affected side. Suitability depends on individual circumstances and must be assessed by a specialist.

Key Takeaways

Sudden hearing loss in one or both ears should be evaluated promptly. Possible causes range from temporary problems such as earwax, fluid, or infection to which may result from disorders affecting  the inner ear or hearing nerve, although the cause is often unknown.

Because the cause cannot be determined reliably based on the symptoms alone, an ear examination, hearing test, and ENT assessment are important to identify the underlying cause and determine the most appropriate treatment.

If your hearing does not fully recover after medical treatment, a hearing professional can assess the impact of the hearing loss and discuss longer-term hearing support, including hearing aids and, for suitable candidates, cochlear implants.