Sudden Sensorineural Hearing Loss
Family physicians are often the first point of contact for patients suffering from sudden hearing loss. Sudden sensorineural hearing loss (SSNHL) is defined as a sudden decrease in hearing of 30 dB or more at three consecutive frequencies. In most cases, the cause of sudden sensorineural hearing loss is idiopathic.
- Acute onset of hearing loss over a window of 72 hours
- Usually unilateral but can be bilateral
- Typically noticed upon waking or when using the telephone
- 70% of cases also experience tinnitus
- 50% of cases also experience vertigo
IMMEDIATE REFERRAL TO A CERTIFIED AUDIOLOGIST FOR A HEARING EVALUATION IS RECOMMENDED.
Our clinics will always prioritize potential SSNHL cases and have your patient assessed the same day. If a SSNHL is diagnosed, immediate referral to ENT is recommended unless the referring physician can provide corticosteroid therapy at their discretion.
Please follow the link below for current evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SSNHL:
When to refer
Changes in hearing sensitivity are often gradual and go unnoticed for several years. Therefore, it is important that adults go beyond the baseline hearing assessment and have their hearing assessed routinely as part of their regular healthcare.
- Adults aged 18 to 54 without a known hearing loss and without any known risk factors for hearing loss should have routine hearing assessments every 5-10 years.
- Adults aged 55+ should have routine hearing assessments every 2-years.
Below is a list of health conditions that are commonly linked to hearing loss and may warrant a referral to a certified audiologist for a comprehensive hearing evaluation.
Decreased Hearing and Communication Difficulties
- Difficulty hearing in noise
- The perception that everyone is mumbling
- “Bluffing” – pretending to hear by nodding one’s head
- Asking frequently for repetition
- Difficulty hearing the television and/or on the telephone
- Difficulty hearing women, children and high-pitched voices
Tinnitus is the perception of sound (ringing, hissing, buzzing, whooshing, etc.) in one’s ears and/or head without the presence of an actual sound. Tinnitus is often a symptom of a disorder of the auditory system and therefore warrants an audiological assessment by a certified audiologist.
Tinnitus can be associated with:
- Disorders of the outer ear (Excessive ear wax, foreign object in the ear canal, perforated eardrum)
- Disorders of the middle ear (ear infections, otosclerosis, benign tumors)
- Disorders of the inner ear (hearing loss, noise exposure, Meniere’s Disease)
Patients referred to our clinic for further investigation of tinnitus will first receive a comprehensive hearing evaluation. If deemed necessary by the audiologist, a tinnitus evaluation may also be recommended. All tinnitus patients are counselled on tinnitus coping, management and sleeping strategies and are provided with a tinnitus management booklet.
Please visit our Tinnitus page for more information on tinnitus and other potential causes.
Vertigo typically occurs due to a disorder of the vestibular system in the inner ear, on the vestibular nerve or in the brainstem.
While referral to an ear, nose and throat specialist and/or a neurologist may be warranted, a comprehensive hearing evaluation and case history should also be completed by a certified audiologist any time a patient presents with vertigo. Also, most ear, nose and throat specialists require a hearing assessment by an audiologist before examination.
Following your patient’s referral to our clinic, you will be provided with a detailed audiological report outlining recommendations for further medical referral, if necessary.
A direct causal relationship between untreated hearing loss and dementia has been observed. It is believed that untreated hearing loss leads to decreased stimulation of the auditory nerve resulting in decreased stimulation of the of the auditory cortex and consequently an increased risk of dementia. Research also suggests that treatment of hearing loss via amplification reduces one’s risk of dementia to that of an individual with normal hearing. For more information on hearing loss and dementia please click here.
Research is starting to suggest that high blood glucose levels associated with diabetes may cause damage to the blood vessels and nerves of the inner ear similarly to how diabetes can be damaging to many other parts of the body. For more information on hearing loss and diabetes please click here.
The inner ear is highly-vascularized making it especially sensitive to blood flow and any abnormalities in the cardiovascular system. Low-frequency hearing loss has been associated with cardiovascular diseases such as cerebrovascular and peripheral arterial disease. For more information on hearing loss and cardiovascular disease please click here.
Individuals suffering from untreated hearing loss are found to be more susceptible to anxiety, sadness and feelings of insecurity. Also, communication challenges resulting from untreated hearing loss can lead to social isolation and decreased confidence and self-esteem. For more information on hearing loss and depression please click here.
Our clinics offer wax removal services to our hearing aid patients. Our clinicians use microsuction to remove wax from patient’s ears. Microsuction is considered the safest method of wax removal as it allows constant observation of the ear canal and does not involve the use of water which reduces the risk of infection. When necessary our clinicians will also use curettage.
Ear wax softening by use of drops is required before wax removal appointments. Audiologist Choice ear drops (active ingredient: 6.5% carbamide peroxide) can be purchased from our clinics. Wax removal drops are not recommended for patients with perforated eardrums.
Contraindications for wax removal via irrigation:
- Signs or symptoms of current infection or a history of recurrent infections
- Current or history of tympanic membrane perforation
- Presence of myringotomy tubes
- History of ear surgery
- History of systemic diseases increasing one’s risk of infection