Sudden hearing loss: why acting fast could save your hearing

Sudden deafness is relatively uncommon, but not rare. Statistics report that up to 27 people in 100,000 experience it.

Some awake to find that they have suddenly lost hearing in one ear overnight. Many people dismiss this as earwax or a minor infection, but it could be something far more serious, including sudden sensorineural hearing loss (SSNHL). This condition involves a rapid loss of hearing in the inner ear or auditory nerve, usually within 72 hours. It is considered a medical emergency because, without prompt treatment, the damage can become permanent.

What Is SSNHL and why is it so urgent?

SSNHL affects the delicate structures of the inner ear, often without warning. The formal definition is a hearing loss of at least 30 decibels across three consecutive frequencies on an audiogram, typically in one ear. Symptoms include muffled hearing, ringing in the ear (tinnitus), and sometimes dizziness. While the exact cause is often unknown, possible triggers include viral infections, autoimmune reactions, or reduced blood flow to the cochlea. The urgency lies in the fact that hair cells in the inner ear can suffer irreversible damage within days.

Steroids: the best chance for recovery

The most widely recommended treatment for SSNHL is high-dose corticosteroids, either taken orally or injected directly into the middle ear. Steroids reduce inflammation and improve blood flow, giving the inner ear the best chance to recover. Clinical guidelines stress that treatment should start within 72 hours of onset, but can still have a positive impact when started within 14 days of onset. Studies show that patients treated promptly are up to five times more likely to regain their hearing compared to those who wait or whose treatment is delayed. Delay can mean the difference between full recovery and lifelong hearing loss.

There is no certainty that steroids will work, but the vast majority of ENT practitioners give them, and research has demonstrated that the sooner they are given, the greater the chance of them having a positive effect.

When delay becomes negligence

Unfortunately, many cases of SSNHL are misdiagnosed as minor ear problems such as wax buildup or sinus issues. If a healthcare provider fails to recognize the symptoms and does not refer the patient for urgent assessment or start steroid therapy quickly, this can lead to permanent hearing loss and disability. In legal terms, such delays may amount to medical negligence, especially when guidelines clearly recommend immediate action. Patients who suffer irreversible hearing loss because of delayed treatment may have grounds to pursue compensation.

Alison Johnson, partner in the medical negligence team, has represented clients who have suffered permanent hearing loss due to negligent medical treatment. Alison is aware that life for clients with hearing loss can be challenging because it affects not only hearing, but also communication, social interaction, and emotional well-being. All of these elements will be looked into when a medical negligence claim is being quantified to determine what the client’s needs are and what level of compensation is required to provide those.

SNHL has an impact on daily communication as it reduces the ability to hear speech clearly, especially in noisy environments. Even with hearing aids, understanding conversations can be tiring because the brain works harder to fill in gaps. This often leads to frustration and withdrawal from social situations.

People with SNHL frequently experience feelings of isolation and anxiety. Misunderstandings in conversations can cause embarrassment, and some individuals avoid group settings altogether. Studies show that untreated hearing loss is linked to depression and even cognitive decline over time. SNHL therefore can have a social and emotional impact on life.

SNHL can also cause practical difficulties in everyday life. Tasks that rely on auditory cues, such as phone calls, alarms, or workplace meetings, become harder. Many people need assistive devices such as amplified phones or visual alerts. In professional settings, hearing loss can affect job performance and confidence, especially if accommodations are not provided.

Coping strategies can help with all of these challenges. Hearing aids, cochlear implants, and lip-reading training improve communication. Support groups and counselling can reduce emotional stress. However, adapting takes time and effort, and some individuals still struggle despite technology.