Sudden Deafness

Sudden sensorineural deafness is an otological emergency that requires immediate attention.

Presentation:

Sudden loss of hearing

Possible tinnitus

Note: although hearing loss may occur with wax impaction, it can be distinguished from sudden deafness as it rarely leads to complete deafness.

Causes:

Unknown

Possibilities:

- Vascular occlusion

- Viral infection

- Acoustic neuroma

Examination findings:

tuning form tests suggest dead ear

Investigations:

Serial audiometry

MRI internal auditory meatus to exclude acoustic neuroma

Management:

Bed rest

Steroids

Beta Histidine

Outcome:

30% complete recovery

30% partial recovery

30% no change

Note: perilymph fistula may present with a similar history.

Usually there is a preceeding event associated with a sudden change in pressure. Vertigo and tinnitus are also typical features, but not always present.