This was an interesting case that I read about recently involving a 52 year old man who presented with left hearing loss that occured abruptly the day earlier. He reported a sense of fullness in the ear with some buzzing/ringing. There was no associated dizziness or vertigo which might be indicative of another cause.

What’s important to establish is whether the hearing loss is due to nerve damage (called “sensorineural hearing loss) or due to obstruction or perforation of the ear drum (called “conductive hearing loss”). This can be easily determined in the office setting.

How to distinguish between conductive vs sensorineural hearing loss

A thorough physical exam needs to be performed by inspecting the ear canal and ear drum. Certain tests to assess the functioning of the cranial nerves will also be conducted by your provider.

One way to tell the difference is for the patient to hum softly. If the sound of the humming is louder in the ear with the hearing loss, it suggests a conductive loss. If the sound is heard louder in the good ear, then it suggests a nerve conduction problem.

This patient heard the humming louder in his good ear, indicating a nerve problem.

Treatment

Sudden hearing loss that is determined to be sensorineural needs to be treated quickly before the hearing loss becomes permanent. Treatment usually consists of a high dose of prednisone over a 2 week period followed by a slow taper.  Sometimes, cortisone injections and antiviral medications are given as alternative treatments.

Patients who present with mild hearing loss usually recover their hearing completely with those presenting with moderate or severe hearing loss, regaining less of their hearing.

It’s important to see your provider quickly if you develop an abrupt loss in hearing over a 72 hour period of time. Failure to act quickly could result in permanent damage.

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