Prophylaxis
An important preventive measure of the hearing loss consists in the treatment of causing basic illnesses. The medical adjustment of high blood pressure and a corresponding medical adjustment of diabetes mellitus, an inhibition of blood coagulation in patients with coagulation disorders as well as the adjustment of an elevated cholesterol level and the reduction of a regular stress level should definitely be aimed at here.
Prognosis
The prognosis of a sudden hearing loss is relatively favourable. In 80% of those affected, the signs of a sudden hearing loss disappear completely without permanent impairment. The younger the patients are and the less severe the symptoms, the higher the probability of complete recovery.
In many cases, the symptoms will regress even without treatment of the hearing loss, but may also remain in mild form. Although scientific evidence is still lacking, it is still believed that a prognostic criterion is also the timing of the start of therapy, and that the earlier a therapy is started, the better. About 15,000 to 20,000 people suffer from sudden deafness every year in Germany.
Most of them are patients of both sexes from the age of 40. Characteristically, the patients complain of a sudden hearing loss of one ear during sudden deafness. Dizziness and pressure on the ear are sometimes reported.
Pain practically never exists. In addition, a wadding sensation on the skin of the ear as well as a sudden dizziness is sometimes present. A sudden hearing loss can become noticeable a few days before by tinnitus (ringing in the ears).
The causes of sudden deafness are assumed to be changes in blood flow, increased blood coagulation, thickening of the blood with the formation of a thormbosis and embolism in the inner ear, as well as infectious, tumorous, autoimmunological and traumatic causes. A change in the flow velocity of the blood leads to a reduced supply of hair cells in the inner ear with simultaneous hearing loss. In addition to the Rinne and Weber tests, the ENT physician has access to numerous electronic hearing tests as diagnostic criteria, which provide information about the type of hearing disorder.
In order to exclude one of the numerous, rarer causes of a sudden loss of hearing, the physician should also perform a blood test and, if necessary, a magnetic resonance tomography (MRI) of the head as the hearing loss progresses. The diagnosis of sudden deafness is considered confirmed if the symptoms develop within 24 hours, if there is no pain, if no other causes of the hearing disorders can be found and if a hearing loss of 30 dB in one ear over 8 octaves can be proven. The treatment of sudden deafness is considered controversial, as there is no exact scientific proof and patients without appropriate therapy recover relatively equally often.
A therapy consists of an infusion therapy with blood-thinning drugs, which should restore the flow velocity, as well as in a blood pressure-regulating therapy. If necessary, an anti-inflammatory therapy and an inotropic therapy with local anesthetics can also be performed. As a preventive measure, accompanying and causative main diseases should be medically adjusted and treated (e.g. high blood pressure, cholesterol adjustment, blood thinning, diabetes mellitus adjustment, stress reduction, exercise).
In most cases, a sudden hearing loss heals without any residual symptoms. It is controversial whether this is also the case without medication. The prognosis is the more favorable the younger the patients are and the easier the signs of a sudden hearing loss are.
80% of patients have no remaining complaints after the treatment.If the hearing loss was considered an absolute emergency in the past, studies have shown that a more restrained approach to therapy seems more appropriate. According to the guidelines, sudden deafness should still be treated promptly, but the good prognostic prospects, even untreated, make a corresponding therapy rather critical.