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What is this information about?
This information is about Sudden Sensorineural Hearing Loss (SSNLH) and how it may be treated. It explains:
- what SSNLH is
- the things that can cause SSNLH
- things that can help you cope if you have SSNLH
- how SSNLH is diagnosed
- what treatments there are for SSNLH
- what an intratympanic steroid injection is and the side effects that you could get from having this treatment
- other ways to manage your SSNLH
- where to find further information and support
Why have I been given this information?
You have been given this information because tests that you have had show that you have SSNLH. An intratympanic steroid injection or other treatment may help.
Reading this information will help you to know what to expect from your treatment. It should help to answer your questions about SSNLH and the support that people with SSNHL can get.
What is Sudden Sensorineural Hearing Loss (SSNHL)?
SSNHL is the name for sudden loss of your hearing caused by your inner ear not working properly. It is also called ‘nerve hearing loss’. It usually happens in one ear and comes on over a period of 72 hours (3 days). It is rare to get SSNHL in both ears, but this can happen.
When you get SSNHL you may also get these symptoms at the same time:
- ringing in your ears (tinnitus)
- dizziness (feeling unsteady or that your head is spinning)
- feeling sick or being sick (nausea or vomiting)
Around five to thirty people in every 100,000 will get SSNHL each year in the UK.
What can cause this SSNHL?
SSNHL is usually caused by problems in the inner ear. For most people we cannot tell exactly what has caused these problems, but causes can include:
- a viral infection of the cochlea. The cochlea converts sounds into nerve messages and sends them to the brain so we can hear.
- Meniere’s disease. This is an autoimmune disease. These can happen when your immune system is overactive. This causes it to attack and damage your body’s own tissues.
- an injury caused by an accident such as a knock to your head (a traumatic injury).
- a medicine that harms your inner hear as a side effect (an ototoxic drug).
How do you find out whether I have SSNHL (diagnose SSNHL)?
You will have a hearing test called an ‘audiogram’. This measures the amount of sound you can hear at different frequencies (high, medium, and low). It tells us the type of hearing problem that you have and how much hearing you have lost. The audiogram helps your doctors to find the best treatment for your hearing loss.
Illustration showing an example of the results of an audiogram:
How might you treat my hearing loss?
Between one in three to two in three of people with SSNHL get some or all of their hearing back in the first two weeks. Sometimes this happens without them needing further treatment.
Your doctor may give you strong steroid medication to start with. Research shows that this may be the best treatment. This is usually given to you as pills (oral medication).
Some people cannot take pills, or the pills do not work for them. If this happens to you, we may give you a steroid injection into your eardrum (your tympanic membrane).
You may also have an MRI (magnetic resonance imaging scan) to see if you have a benign tumour (growth that is not a cancer) of your vestibular nerve which is causing your hearing loss. Your vestibular nerve sends the signals that mean you can hear from your inner ear to your brain.
What are Intratympanic (TM) Steroid Injections?
An intratympanic (TM) steroid injection is the best way of getting a high dose of steroid medication directly into your eardrum. Steroid medication injected in this way goes exactly where it needs to be to reduce the inflammation and swelling in your cochlea which can cause hearing loss.
Will I feel any pain when I have an TM steroid injection?
We will give you a local anaesthetic to numb the area before you have the IM steroid injection so you should not feel any pain. You may feel a little discomfort.
Most people will need to lie flat for around fifteen to twenty minutes after the injection to help the medication to work well.
Might I need to have the injection done more than once?
A few people will need to come back to the hospital for further IM steroid injections. You may need up to four injections spread over a few weeks.
What might happen when I am having the injection or afterwards?
Like most medicines, TM injections can have some side effects. They do not happen often but can include:
- having ear pain
- feeling dizzy. This does not usually last for long.
- your tongue feeling numb
- infection in your ear
- feeling sick (nausea) and vertigo (a spinning feeling)
- a drop in blood pressure during the injection. This is rare.
Be aware
If you have any of these side effects and they do not go away or they get worse do contact the ENT (Ear, Nose and Throat) Department straight away.
Should I arrange for someone to take me home after my TM steroid injection?
Yes. Do make sure that you have someone to take you home after an intratympanic injection as you may, for example, feel dizzy.
Are there any other things which could help me to manage my hearing loss?
Yes. Your Audiologist will explain what these are and talk with you about which may be good for you. They can direct you to further information and support. Options could include:
- hearing aids
- communication tactics
- audiology rehabilitation
- cochlear implants
- assistive listening devices (personal hearing loops)
- speech reading
- counselling
How might can I cope with my sudden change in hearing?
It can be hard to accept sudden hearing loss and the changes that it can make to your life. People who have sudden hearing loss often feel lonely, frustrated, and scared. The good news is that there are many practical things you can do to:
- cope with your emotions
- help you to return to doing things that you were able to before your hearing loss
What support groups are available for my hearing loss?
- Hearing Link – Living with hearing loss
- Hearing Loss Association of America (HLAA)
- Royal National Institute for Deaf People (RNID)
- National Deaf Children’s Society (NDCS)
- Hear the World – Supporting childrens’ hearing development.
Will my hearing ever recover?
Whether or not your hearing recovers after SSNHL, and how much it recovers, is different for everyone.
- You have the best chance of your hearing recovering if we are able to diagnose and treat your condition soon after your SSNHL comes on.
- The greatest amount of recovery is likely to happen within the first one to two weeks after you got SSNHL hearing loss. For some people, recovery can take up to a year after they first got SSNHL.
Where can I get further information about hearing loss?
You can find more information about hearing loss on:
The RNID (Royal National Institute for Deaf) offers an online hearing screening test.
You could use this before you see a GP to check your hearing if you think you may have hearing loss.
Be aware
If you think you have SSNHL do please seek medical help from a GP or NHS 111 straightaway.
Who can I contact for any questions or worries after I have read this information?
If you have any problems or are worried about anything, please do contact us in the Ear, Nose and Throat Outpatient Department.
Royal Sussex County Hospital, 01273 696955 Ext. 4813
In an emergency, please dial 999 and ask for an ambulance or go to your nearest Emergency Department.
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This leaflet was authoured by Dr Syed Ammar Husain (Academic FY1) and Mr Robert Grounds (ENT Consultant).
This information is currently intended for patients receiving care in Brighton and Hove.
The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.