Sudden hearing loss, also known as sudden sensorineural hearing loss (SSHL), is a rapid and unexplained drop in hearing—typically in one ear. It can occur all at once or over a span of a few days. This condition is considered a medical emergency, and seeking treatment right away can make the difference between full recovery and permanent hearing damage.
Many people first notice SSHL when they wake up unable to hear in one ear or when they try to use the phone and realize sound isn’t coming through. In some cases, the onset is dramatic, accompanied by a popping sensation or ringing in the ear. In others, it’s more subtle, progressing over hours. Either way, timely action is crucial.
Key Takeaways
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Sudden hearing loss affects roughly 1 in 5,000 adults annually, though it may be underreported.
Steroid treatments are most effective within the first 14 days of symptom onset.
Without treatment, SSHL can lead to permanent hearing loss—early diagnosis is essential.
What Causes Sudden Hearing Loss?
Doctors still don’t fully understand what causes most cases of SSHL, which makes the condition even more frustrating for those affected. In about 85–90% of cases, no specific cause is found. However, there are several suspected contributors:
Possible Triggers
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Viral infections, such as the common cold or upper respiratory viruses
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Autoimmune conditions, where the body mistakenly attacks inner ear cells
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Circulation problems that reduce blood flow to the cochlea
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Trauma or head injury
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Neurological disorders, including multiple sclerosis
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Ototoxic medications (certain antibiotics, chemotherapy drugs, or diuretics)
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Acoustic neuroma, a noncancerous tumor on the auditory nerve
Although rare, these underlying conditions highlight the importance of seeing a doctor right away to rule out serious causes and start treatment.
Symptoms to Watch For
Sudden hearing loss usually affects only one ear. The symptoms can range in intensity but tend to have a few things in common:
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Rapid hearing decline in one ear (over minutes to days)
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A "popping" sound or sensation
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A feeling of fullness or pressure in the ear
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Dizziness or imbalance
These signs can be confusing, especially if they come on gradually. If you notice any of these symptoms—especially if they don’t improve within 24 hours—it’s time to act quickly.
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Why SSHL Is a Medical Emergency
Time is one of the most important factors in treating sudden hearing loss. The sooner treatment begins, the higher the likelihood of hearing recovery.
Most people treated with corticosteroids within 10–14 days regain some or all of their hearing. Delays in diagnosis can lead to permanent loss. That’s why urgent evaluation—ideally by an ENT (ear, nose, and throat doctor)—is essential.
If symptoms like slurred speech, weakness, dizziness or imbalance, or facial drooping accompany hearing loss, call 911 immediately, as these may signal a stroke.
How Is Sudden Hearing Loss Diagnosed?
If you suspect SSHL, a healthcare provider will begin with a physical exam and questions about your health history. Common steps in diagnosis include:
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Otoscope exam to rule out earwax or infections
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Audiometry (hearing test) to measure hearing loss
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Tympanometry to assess middle ear function
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Blood work to identify infections or immune issues
Doctors typically diagnose SSHL when there is a loss of at least 30 decibels in three consecutive frequencies on a hearing test.
Treatment Options for SSHL
Steroid Therapy
The most common and effective treatment is corticosteroids, which reduce inflammation in the inner ear. These may be administered as:
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Oral steroids (e.g., prednisone)
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Injected steroids directly into the ear (intratympanic)
Both delivery methods have shown positive results, but intratympanic injections may be favored when oral steroids are not tolerated.
Other Treatments
Some doctors may recommend:
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Hyperbaric oxygen therapy to improve inner ear oxygenation
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Antivirals or antibiotics if an infection is suspected
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Lifestyle changes or medication adjustments if underlying conditions are found
Emerging therapies like batroxobin (an enzyme that improves blood flow) are still under investigation.
What If Treatment Doesn’t Work?
Roughly 15% of patients may have permanent hearing loss, even with timely treatment. When that happens, hearing aids or assistive devices can offer support:
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Traditional hearing aids for mild to moderate loss
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Bone-anchored hearing aids (BAHAs) for more profound loss
These technologies don’t restore hearing fully but can improve communication and reduce the strain of hearing loss in everyday life.
Preventing Sudden Hearing Loss
Because most causes are unknown or unpredictable, there is no guaranteed way to prevent SSHL. However, you can reduce general risk by:
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Managing chronic conditions like high blood pressure or diabetes
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Asking your doctor about the side effects of medications
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Treating upper respiratory infections early
Building general ear health habits may help lower your risk of complications.
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Frequently Asked Questions
How quickly should I get help for sudden hearing loss? Immediately. Treatment is most effective within the first 10 to 14 days. Don’t wait for symptoms to improve on their own.
Can sudden hearing loss go away on its own? Yes, in about 50% of cases, some or all hearing returns without treatment. But seeking care gives you the best chance at recovery.
Does SSHL affect both ears? It almost always affects just one ear. If both ears are impacted, it could point to a different issue.
What’s the difference between temporary and permanent hearing loss? Temporary loss may be due to wax buildup or infection, and it usually resolves with treatment. SSHL can become permanent if not treated quickly.
Is sudden hearing loss painful? Not usually. The loss itself is often painless, but may be accompanied by pressure, ringing, or dizziness.
