Hearing loss is an acute and sudden partial loss of hearing with concomitant hearing loss in one, and in rare cases, both ears. The severity of the hearing loss ranges from hardly noticeable to complete deafness. In Germany, about 15,000 to 20,000 people a year are affected by sudden deafness. Both women and men are affected about equally often. Children and adolescents suffer less frequently from this disease, while men and women over 40 years of age are the most common group of sufferers.
In order to describe the causes, one must distinguish between symptomatic sudden deafness and idiopathic sudden deafness. Symptomatic sudden deafness can be caused by etiologies such as tumors or nerve damage. Among the tumors, the acoustic neuroma is one of the most common benign tumors that can cause sudden deafness.
It is a proliferation of the nerve sheath of the nervus vestibulocochleraris. Compression of the nerve can cause dizziness, gait insecurity, eye tremors and tinnitus in addition to hearing loss. It is untypical for the symptoms to occur suddenly, as can be observed in the majority of sudden deafness.
Further differential diagnostic causes, which are to be distinguished from idiopathic sudden deafness, are The causes of a sudden deafness are thus manifold. Therefore, the more important are the possible accompanying symptoms and the form in which they develop. Even a simple cold with swelling of the tonsils can lead to a ventilation problem in the middle ear if the tube is blocked, which in turn can cause an inflammation of the middle ear with hearing loss.
The idiopathic sudden hearing loss, on the other hand, occurs suddenly and within a few seconds to minutes a painless, unilateral hearing loss occurs. The cause of this is not yet clear, it is suspected that there are circulatory problems in the inner ear. Frequently one finds connections with stress situations.
In stressful situations, the body releases more catecholamines (adrenaline, noradrenaline) and these have a vasoconstrictive effect. It is suspected that hearing loss in stressful situations results in a secondary reduced blood flow to the ear due to vasoconstriction. This explanation is also used for hearing loss in the context of a burnout syndrome or depression.
Both clinical pictures are associated with increased cortisone levels. Cortisone has a vascular-centering effect, i.e. vasoconstriction occurs in the periphery and vasodilation in the center (the vital organs). For the blood flow in the ear this means a further decrease.
Another assumption is the connection between sudden deafness and strokes. It is believed that in some cases sudden deafness can be a harbinger of a possible stroke. However, this has not yet been proven.
- Diseases of the central nervous system: multiple sclerosis, meningitis, loss of cerebrospinal fluid
- Diseases of the ear: Inflammation of the inner ear (labyrinthitis), barotrauma (damage to the middle or inner ear caused by extreme pressure changes in the environment), Meniere’s disease, perilymph fistula or obstruction of the external auditory canal by earwax.
- Taking ototoxic drugs, such as selected antibiotics.
- Hearing loss in the sense of a viral infection (e.g. mumps, zoster oticus, adenoviruses)
- Psychogenic acute hearing loss (usually occurs on both sides)
- Circulatory disturbances due to vertebral body wear on the cervical spine or hearing loss after whiplash trauma affecting the cervical spine.
The sudden hearing loss of one ear is characteristic. Often, shortly before the hearing loss/failure to hear, patients experienced a longer-lasting noise, such as monotonous whistling or humming, also known as tinnitus. Pain in the ear practically never occurs during a sudden hearing loss, although in some cases a feeling of pressure on the ear has been reported.
Simultaneous symptoms of dizziness may also occur at times (see: Dizziness caused by diseases of the ear). The sudden, one-sided hearing loss can lead to so-called double hearing (diplacusis) as well as to a feeling of numbness and a wadding sensation.Patients with sudden deafness are usually very frightened and insecure, as many have never had a sudden hearing loss before and sudden single ear hearing is completely unfamiliar. In some patients, the sudden loss of one ear also triggers an acute dizziness syndrome with a tendency to fall, as the body is used to using both ears to measure balance.