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Thread: Sudden Unilateral Hearing Loss Questions

  1. #1

    Default Sudden Unilateral Hearing Loss Questions

    Hi.

    I experienced Sudden Sensorineural Hearing Loss (SSHL) in my LEFT ear June 1 which was not diagnosed by an ENT until 90 days later even with repeated visits to doctors during June, July & August (GP, ER walk-in clinic etc...)
    On day 90 the ENT gave me a Intra Tympanic Steroid injection and a second 6 days later. Neither helped. However I am left with a "moderate" sized HOLE in my eardrum which has not healed in over 2 months.
    A few questions:

    1) How common is it to be left with a permanent hole in you eardrum from this procedure?
    2) What are the likely causes?
    3) What hearing aid would likely be most helpful for my UNILATERAL hearing loss? I am currently trying the Resound Cala 8 from Costco

    BTW my hearing is normal in my right ear and MRI was OK.
    Booked to consult with a different ENT Dec 8

  2. #2

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    I'm not sure about the hole in your eardrum. But for hearing aids, you might want to look into a CROS system if your one ear is pretty bad. That would pipe the sounds to your normal ear. Otherwise if it's not too bad then a single hearing aid should suffice.

  3. #3
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    Anytime you have a sudden hearing loss it should be bumped up to an emergency visit to see an ENT, any doctor that doesn't refer you to one is guilty of malpractice IMO! I know several people who have permanent holes in their eardrums and it has left them with either a mixed loss or just a conductive loss. A conductive loss is easier to get to more or less normal hearing with a HA as long as you can amplify it high enough, a mixed loss depending on how severe the SSHL is, a HA can help but it won't bring your hearing back to what it was prior to the sudden hearing loss. The hole in your eardrum could of been caused by a number of things: loud noise too close to the ear, rapid change in pressure such as in flying or scuba diving, foreign object in the ear (q tip), slap to the side of the head, etc. Small holes normally heal in a couple months, larger ones take longer and some never heal and have to be surgically repaired by doing a tympanoplasty which grafts your own tissue over the hole or a myringoplasty where they surgically put a gel or special kind of paper over the hole. if you don't get it fixed you have to use earplugs when taking a shower or swimming to keep water from entering your middle ear. Leaving it open makes you more susceptible to future ear infections, mastoiditis and vertigo. The HA that is best for you is the HA that you like and allows you to hear the best, since everyone hears differently what is the best for one person could be less than perfect for another person, only you will be able to answer which is best for you. Good luck!
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  4. #4

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    Quote Originally Posted by Neville View Post
    Perforations as a result of intra tympanic steroid injections happen in just under 2% of people undergoing the treatment. Most of those heal on their own, and your doctor is probably waiting to see if yours will do that. If it doesn't, you should ask about whether it can/should be patched.

    As to why your ear was one of the ones that perforated and hasn't recovered quickly, that's probably impossible to know. You're at greater risk of perforation if you've had radiation to the head. If you're a smoker or your diet is a bit lacklustre, healing in your body is probably slowed over all. Your tympanic membrane might be thinned or its cell renewal process might be a bit dysfunctional if you are older and/or if you have a strong history of middle ear infection. But it could just be luck of the draw.

    There's still a fair bit of controversy about whether steroids are that helpful with sudden loss. A number of people improve after steroid treatment, but a number of people improve without steroid treatment. The treatment was oral steroids for a long time, but I remember a big review paper coming out a few years ago arguing that based on our current (lack of good) evidence, oral steroids were just a hail mary and that doctors shouldn't necessarily prescribe them for lack of a better treatment because you're putting your patient at risk for the side effects of the steroids themselves without strong evidence that they do anything. Intra tympanic steroid injections is a more recent treatment and it looking more promising, but again I don't know that I'd call it STRONG evidence at this point.

    What hearing aid would be best would depend on your loss. Trialing is a good idea. Sometimes a sudden sensorineural loss will do a number on your speech clarity so that putting a hearing aid in that ear just makes things worse. In that case, Phonak currently has the best CROS option. Otherwise, there will probably be a lot of good options.
    I saw the hole on a screen at Costco and it seems to cover 30% of the tympanic membrane. The ENT used the term "moderate" to describe it but I would say the hole is "significant". My personal feeling is that the ENT was careless.
    My GP referred me to another ENT b/c of my concerns about the ENT that did the injections. Apparently others have expressed similar concerns.

    No "radiation to the head", not "a smoker" and my diet is very good. Although I am 70 I am in good health.

    Neville, what is the Phonak CROS option? Sounds like a HA for each ear. Thanks, Gary
    Last edited by Gary T; 11-19-2016 at 05:02 PM.

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