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First sign of hearing loss: seek treatment

by Heather Woolwine
Public Relations
When rap star Foxy Brown suffered sudden hearing loss, the effect was dramatic and swift. As she told People magazine, “I started breaking down in tears and screaming, and I couldn’t even hear myself scream,” she said. “I ran outside to my truck and honked the horn. Nothing. I ran back inside and dialed a number on the phone. Nothing. Then I started breaking down in tears and screaming and I  couldn’t even hear myself scream. That’s when I knew there was a problem.”
 
While some type of hearing loss affects more than 40 million people in this country, what Brown experienced is rare, according to Ted Meyer, M.D., Ph.D., Otolaryngology—Head and Neck Surgery. Her loss was sudden and severe and in both ears. Brown’s biggest mistake however, by her own account, was not seeking treatment with the first signs of hearing loss.
 
There are two types of hearing loss, conductive and sensorineural. Problems associated with the structures of the outer or middle ear block sound from entering the inner ear and results in conductive hearing loss. Symptoms of this type of hearing loss include hearing loss itself, ringing or pressure, and acute conductive hearing losses often follow an upper respiratory tract infection, trauma, swimmer’s ear, or too much ear wax.
 
These problems are often easily treated through removal of wax and debris or surgery, such as tubes or a procedure to repair the eardrum or ossicles (middle ear bones). If they’re needed, hearing aids work well for patients with this kind of hearing loss.
 
Sensorineural hearing loss is typically harder to deal with and involves damage to the structures of the inner ear or auditory nerve. Numerous causes exist for this type of loss, and a very common problem that everyone faces today is exposure to excessive noise.
 
Sudden sensorineural hearing loss, the kind that Brown experienced, is typically harder to deal with than a gradual loss. Those who experience this type of hearing loss often present with symptoms like an upper respiratory infection, fullness or pressure, or a ringing or buzzing in the affected ear. This type of loss pounces all at once, and indicates a serious problem with a person’s inner ear. Because of the nature of the inner ear’s fluid-filled structures, surgeons cannot operate on it; therefore the loss suffered this way is often permanent.
 
“The more dizziness or vertigo associated with hearing loss, the worse it is,” Meyer said. “Patients with vertigo and hearing loss experience less recovery than those who just have hearing loss. Most patients only experience loss in one ear. Foxy’s case is actually very rare.”
 
The causes of sudden hearing loss are numerous and include noise exposure, head trauma, drug toxicity, vascular problems, infections, and even certain autoimmune diseases. “One form of sudden hearing loss occurs when someone goes to a concert and comes home with tinnitus and is not able to hear well. Most people recover their hearing from this noise trauma during the next couple of hours, but after multiple noise exposures, the hearing loss becomes permanent.
 
“When most sudden hearing loss occurs, patients do nothing and hope that their hearing returns,” Meyer said. “Up to 50 percent of patients who experience sudden hearing loss regain some or all of their hearing without treatment. Some patients seek out their primary care physicians or go to an emergency room. ”
   
Meyer also noted the importance of a prompt referral from a primary care or emergency room physician to an otolaryngologist. It is standard procedure for Meyer to see any patient with sensorineural hearing loss the day he receives the call from the referring physician. “The sooner we make the right diagnosis and start appropriate therapy, the better the chance we have to improve a patient’s hearing,” he said.
   
With a broad range of minimal to profound hearing loss associated with sensorineural hearing losses, numerous treatment options were proposed during the last 100 years. Treatment includes high-dose steroids, and during Meyer’s fellowship, the protocol was to give the patient two intravenous medications to improve hearing. Patients experiencing this type of loss, whether hearing returns or not, should undergo an MRI scan to rule out the presence of an acoustic neuroma, a benign tumor on the balance nerves.
 
 If hearing loss does not improve with treatment, it usually becomes permanent. When the loss is in the severe-to-profound range in both ears, then hearing aids produce little benefit. This may be the case for Brown, and Meyer mentioned that someone in the same situation is a prime candidate for cochlear implantation.
 
The bottom line for Meyer and his colleagues, “if patients experience sudden hearing loss and it doesn’t go away on its own within a few days, then you need to see a physician as soon as possible. The earlier a patient receives treatment, the better chance he or she has at making a better recovery.”
 
For more information, visit http://wwwmuschealth.com/ent/.
 

Friday, Nov. 25, 2005
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.