How does it manifest itself?
Most often, one ear is affected. A person feels stuffy, as if a plug has been inserted into the ear, sounds become quieter and distorted, the interlocutor’s speech sounds unintelligible, especially on the phone. There is almost always noise in the ear - ringing, humming or whistling. Some patients experience dizziness or unsteadiness, indicating involvement of the vestibular portion of the inner ear. There is usually no pain, no discharge from the ear, and it is the absence of pain that often creates the false impression that nothing bad has happened.
- Stuffiness and woolly sensation in the ear
- Sudden hearing loss within hours
- Noise or ringing in the ear
- Distortion of sounds, unintelligibility of speech
- Dizziness in some patients
- No pain or discharge
Possible reasons
In most cases, a specific cause cannot be identified and the condition is considered idiopathic. The role of viral damage to the inner ear, impaired blood supply, and immune mechanisms is suggested. In some patients, specific causes are found: barotrauma during flying or diving, acoustic trauma, head trauma, inflammation of the middle ear, acoustic neuroma, autoimmune diseases, side effects of certain medications. Neurological causes are considered separately, in which hearing loss is combined with other symptoms and requires emergency assistance.
- Idiopathic form without an established cause
- Viral infection of the inner ear
- Impaired blood supply to the cochlea
- Barotrauma during flight or diving
- Acoustic and traumatic brain injury
- Acoustic neuroma
- Autoimmune diseases
- Toxic effects of some drugs
Why are the first days important?
The sensitive cells of the inner ear are extremely vulnerable: if the damaging factor acts for a long time, the changes become irreversible. That is why treatment is considered most effective when it is started in the first days after the onset of symptoms, and its effectiveness decreases as it delays. A typical mistake is to wait a week in the hope that the congestion will go away on its own, to instill drops to soften the wax, or to warm the ear. The correct tactic is simple: if you notice a sharp decrease in hearing, contact an ENT doctor on the same day, and if it is impossible to get an appointment, look for on-duty help.
- Early treatment increases the chance of recovery
- Delay reduces the effectiveness of therapy
- You can't wait weeks for spontaneous improvement
- Do not self-medicate with drops and heating
- Same day treatment is the best tactic
Survey
The doctor examines the ear canal and eardrum to immediately rule out simple causes: cerumen plug, foreign body, acute otitis media. A hearing test is then performed to determine the type and extent of the loss—this is what distinguishes inner ear damage from middle ear problems. Magnetic resonance imaging of the inner ear and brain is mandatory to exclude acoustic neuroma and other formations. Additionally, general tests, coagulation parameters, blood sugar and, if indicated, markers of autoimmune diseases and infections are assessed.
- Examination of the ear and eardrum
- Hearing examination to determine the type of hearing loss
- Tympanometry
- MRI of the inner ear and brain
- General and biochemical blood test
- Assessment of vestibular function in vertigo
Treatment
The basis of treatment is hormonal therapy with glucocorticoids, which is prescribed systemically or injected directly into the tympanic cavity; The choice and regimen are determined by the doctor, taking into account concomitant diseases, primarily diabetes and hypertension. If the cause is identified, it is treated: inflammation of the middle ear, barotrauma, autoimmune process. The patient is advised to rest, avoid noise, smoking and alcohol, and control blood pressure and sugar. If hearing is not fully restored, hearing replacement is discussed after a few months. Persistent noise in the ear is corrected using separate methods, including sound therapy and working with a psychologist in case of severe discomfort.
- Glucocorticoids systemically or into the tympanic cavity
- Start therapy as early as possible
- Treatment of the identified cause
- Limiting noise, quitting smoking and alcohol
- Blood pressure and sugar control
- Control hearing test after treatment
- Hearing aid for incomplete recovery
- Techniques for dealing with tinnitus
