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Woman with sudden sensorineural hearing loss holding ears.

Many things you know about sensorineural hearing loss could be wrong. Alright, perhaps not everything is false. But there is at least one thing worth clearing up. Typically, we think that sensorineural hearing loss comes on gradually while conductive hearing loss happens suddenly. Actually, sudden sensorineural hearing loss often goes undiagnosed.

Is Sensorineural Hearing Loss Usually Slow Moving?

When we discuss sensorineural hearing loss or conductive hearing loss, you could feel a little confused – and we don’t hold it against you (the terms can be quite dizzying). So, here’s a basic breakdown of what we mean:

  • Conductive hearing loss: This form of hearing loss results from an obstruction in the middle or outer ear. This might be because of earwax, swelling caused by allergies or lots of other things. Normally, your hearing will return when the root blockage is cleared up.
  • Sensorineural hearing loss: This type of hearing loss is commonly caused by damage to the nerves or stereocilia in the inner ear. When you think of hearing loss caused by intense noises, you’re thinking of sensorineural hearing loss. Even though you might be able to treat sensorineural hearing loss so it doesn’t get worse in the majority of instances the damage is irreversible.

It’s common for sensorineural hearing loss to happen slowly over time while conductive hearing loss takes place somewhat suddenly. But sometimes it works out differently. Sudden sensorineural hearing loss (or SSNHL) is relatively uncommon, but it does happen. And SSNHL can be especially damaging when it’s not treated properly because everyone assumes it’s an unusual case of conductive hearing loss.

Why is SSNHL Misdiagnosed?

To understand why SSNHL is misdiagnosed fairly frequently, it might be practical to look at a hypothetical interaction. Let’s suppose that Steven, a busy project manager in his early forties, woke up one day and couldn’t hear out of his right ear. His alarm clock sounded quieter. So, too, did his barking dog and chattering grade-schoolers. So he did the smart thing and scheduled a hearing test. Needless to say, Steven was in a rush. He was just getting over a cold and he had a lot of work to catch up on. Maybe, while at his appointment, he forgot to bring up his recent condition. And maybe he even inadvertently left out some other significant information (he was, after all, already stressing over getting back to work). And so Steven was prescribed some antibiotics and was told to return if the symptoms persisted by the time the pills had run their course. It’s rare that sensorineural hearing loss occurs suddenly (something like 6 in 5000 according to the National Institutes of Health). So, Steven would normally be fine. But if Steven was really suffering with SSNHL, a misdiagnosis could have substantial repercussions.

Sensorineural Hearing Loss: The Crucial First 72 Hours

SSNH could be caused by a wide variety of conditions and events. Some of those causes might include:

  • Head trauma of some kind or traumatic brain injury.
  • A neurological condition.
  • Particular medications.
  • Problems with blood circulation.
  • Inflammation.

This list could continue for, well, quite a while. Your hearing specialist will have a much better concept of what problems you should be looking out for. But the main point is that many of these root causes can be dealt with. There’s a chance that you can reduce your lasting hearing damage if you deal with these hidden causes before the stereocilia or nerves become permanently harmed.

The Hum Test

If you’re having a bout of sudden hearing loss, like Steven, there’s a quick test you can perform to get a rough understanding of where the issue is coming from. And it’s fairly simple: hum to yourself. Choose your favorite tune and hum a few measures. What does it sound like? Your humming should sound the same in both ears if your loss of hearing is conductive. (The majority of what you’re hearing when you hum, after all, is coming from inside your own head.) It’s worth discussing with your hearing specialist if the humming is louder on one side because it may be sensorineural hearing loss. Ultimately, it is possible that sudden sensorineural hearing loss could be wrongly diagnosed as conductive hearing loss. So when you go in for your hearing exam, it’s a good idea to mention the possibility because there could be significant repercussions.