Sudden sensorineural hearing loss (SSNHL) is a medical emergency characterised by rapid hearing loss, typically occurring within 72 hours. This condition affects the inner ear or nerve pathways from the inner ear to the brain, resulting in hearing reduction across consecutive frequencies. Whilst hearing loss usually affects one ear (unilateral), bilateral sudden hearing loss can occur in some cases, requiring even more urgent medical attention.
Sudden Hearing Loss Treatment in Singapore
Sudden hearing loss can be concerning and may affect your daily activities without warning. Whether you’ve woken up with muffled hearing or noticed changes over several hours, seek prompt medical attention for proper evaluation. At our clinic, our ENT specialist understands the importance of timely sudden hearing loss and provides comprehensive evaluation and clinical interventions that may help support hearing recovery. Early medical consultation is important when experiencing sudden hearing loss – prompt intervention may help with treatment outcomes.
*Individual results and timelines may vary.*
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
What is Sudden Hearing Loss?
Types of Sudden Hearing Loss
Idiopathic Sudden Sensorineural Hearing Loss
This is a type where no specific cause can be identified despite thorough investigation. The hearing loss occurs spontaneously without obvious triggers or warning signs. Treatment may involve corticosteroids and supportive therapies aimed at reducing inflammation and promoting recovery.
*Individual results and timelines may vary.*
Secondary Sudden Hearing Loss
This type has an identifiable underlying cause, such as head trauma, ototoxic medications, or Ménière’s disease. The hearing loss develops as a consequence of the primary condition. Treatment focuses on addressing both the underlying cause and the hearing loss itself.
Autoimmune-Related Sudden Hearing Loss
The body’s immune system mistakenly attacks the inner ear tissues, causing rapid hearing deterioration. This type may affect both ears and can respond to immunosuppressive therapy when diagnosed early. Patients may have other autoimmune conditions or symptoms.
*This treatment is administered as part of a comprehensive plan supervised by a healthcare professional.*
Causes & Risk Factors
Causes
- Viral infections affecting the inner ear or auditory nerve
- Blood circulation problems reduce oxygen supply to the cochlea
- Inner ear membrane ruptures, causing fluid imbalances
- Autoimmune disorders targeting inner ear structures
- Ototoxic medications damage hair cells
- Head trauma or acoustic trauma from noise exposure
- Tumours pressing on the auditory nerve (acoustic neuroma)
- Ménière’s disease episodes
Risk Factors
- Certain age groups may be more susceptible
- Previous episodes of sudden hearing loss
- Cardiovascular disease or diabetes
- Recent upper respiratory infections
- Stress levels or fatigue
- Exposure to loud noise environments
- Family history of hearing disorders
- Use of certain medications (high-dose aspirin, loop diuretics, chemotherapy drugs)
- Smoking and alcohol consumption
Signs & Symptoms
Immediate Symptoms
- Sudden reduction or complete loss of hearing in one ear
- Sensation of ear fullness or pressure
- Difficulty understanding speech, especially in noisy environments
- Sounds appearing muffled or distorted
- Inability to hear high-frequency sounds
Associated Symptoms
- Tinnitus (ringing, buzzing, or whooshing sounds)
- Dizziness or vertigo
- Balance problems or unsteadiness
- Nausea related to vestibular involvement
- Ear pain (uncommon but possible)
Progressive Symptoms
- Worsening hearing loss over hours to days
- Increasing tinnitus intensity
- Development of hyperacusis (sound sensitivity)
- Difficulty localising sound sources
- Cognitive fatigue from straining to hear
Sudden hearing loss typically manifests upon waking or may develop rapidly over several hours. Some patients report a “pop” sensation immediately before the hearing loss occurs, followed by immediate hearing reduction and often tinnitus.
Experiencing these symptoms? Consider seeking medical evaluation promptly.
Consult with an ENT specialist for an accurate diagnosis and appropriate treatment plan.
When to See a Doctor
Sudden hearing loss is a medical emergency requiring immediate evaluation, ideally within 24-48 hours of onset. Seek urgent medical attention if you experience rapid hearing loss in one or both ears, even if it seems mild initially. Red flag symptoms requiring immediate emergency care include sudden bilateral hearing loss, hearing loss with severe headache or neurological symptoms, hearing loss following head trauma, or hearing loss with facial weakness or numbness.
During your consultation, the ENT specialist will perform comprehensive hearing tests and a physical examination to assess the severity and type of hearing loss. Early treatment within the first two weeks, particularly within 72 hours, may offer improved outcomes for hearing recovery. Delaying treatment beyond two weeks may reduce the likelihood of recovering lost hearing. The specialist will also evaluate for underlying causes that may require specific interventions.
*Individual results and timelines may vary.*
Diagnosis & Testing Methods
Clinical History and Physical Examination
Your ENT specialist will conduct a detailed assessment of symptom onset, progression, and associated factors. The examination includes otoscopy to visualise the ear canal and eardrum, along with tuning fork tests to differentiate between conductive and sensorineural hearing loss.
Pure Tone Audiometry
This test measures hearing thresholds across different frequencies to confirm the diagnosis of sudden sensorineural hearing loss. The test quantifies the degree of hearing loss and establishes a baseline for monitoring treatment response. Results are typically available immediately.
Tympanometry and Acoustic Reflex Testing
These tests evaluate middle ear function and help rule out conductive hearing loss causes. They assess eardrum mobility and the stapedius reflex pathway, providing information about middle ear pressure and compliance.
Magnetic Resonance Imaging (MRI)
MRI with gadolinium contrast may be recommended to exclude retrocochlear pathology such as acoustic neuroma or stroke. This imaging is particularly important for patients with asymmetric hearing loss, neurological symptoms, or poor response to initial treatment.
Blood Tests
Laboratory investigations may include complete blood count, inflammatory markers, syphilis serology, and thyroid function tests. Additional specialised tests for autoimmune markers may be ordered if autoimmune inner ear disease is suspected.
Treatment Options Overview
Systemic Corticosteroids
Oral prednisolone or intravenous methylprednisolone is a treatment option for sudden hearing loss. These medications aim to reduce inflammation and swelling in the inner ear, which may help with hearing damage. Treatment typically involves doses administered over a period, followed by a gradual reduction. Starting treatment early after symptom onset may provide better outcomes, though benefit might still occur if initiated later.
Intratympanic Steroid Injections
Direct injection of steroids through the eardrum delivers medication concentrations to the inner ear while reducing systemic side effects. This treatment can serve as therapy for patients unable to take oral steroids or as additional therapy when initial treatment is insufficient. The procedure involves multiple injections over a period, performed in the clinic under local anaesthesia.
Hyperbaric Oxygen Therapy
This treatment involves breathing pure oxygen in a pressurised chamber to increase oxygen delivery to the inner ear tissues. Sessions typically last a specified duration and may require multiple treatments over several weeks. This approach may be considered when combined with steroids, particularly for more significant hearing loss cases.
Antiviral Medications
Though viral infection is suspected in many cases, antiviral drugs like acyclovir or valacyclovir may be prescribed. Some specialists may prescribe these medications in combination with steroids, particularly if viral symptoms preceded the hearing loss. Treatment duration typically spans a specified period.
Rheological Agents
Medications that may improve blood flow, such as pentoxifylline or low-molecular-weight heparin, may be prescribed to support cochlear circulation. These treatments are used in various clinical settings, with varying approaches to effectiveness. They may be considered for patients with certain risk factors.
Hearing Rehabilitation Devices
For patients with incomplete recovery, hearing aids can help improve communication ability and quality of life. Modern digital hearing aids offer sound processing tailored to the specific hearing loss pattern. For significant unilateral hearing loss, CROS (Contralateral Routing of Signal) hearing aids or bone-anchored devices may be recommended.
Every patient’s condition is unique.
Our ENT specialist will assess your specific situation and recommend the most suitable treatment approach for you.
Complications if Left Untreated
Without prompt treatment, sudden hearing loss may become permanent, potentially affecting communication abilities and quality of life. Untreated hearing loss can increase the risk of social isolation, depression, and anxiety as patients may experience challenges with daily interactions. The affected ear may develop chronic tinnitus that can become increasingly difficult to manage over time.
Balance problems and increased fall risk can persist as the vestibular system adapts to unilateral dysfunction. Cognitive changes have been associated with untreated hearing loss. Professional and personal relationships may be affected due to communication difficulties. The window for effective treatment may close rapidly, with a reduced chance of recovery after extended periods without intervention.
*Individual outcomes and timelines may vary.*
Prevention
While many cases of sudden hearing loss occur without warning or identifiable cause, certain preventive measures may help reduce risk. Protect your hearing from excessive noise exposure by using appropriate ear protection in loud environments and following safe listening practices with personal audio devices. Maintain cardiovascular health through regular exercise, a balanced diet, and the management of conditions like hypertension and diabetes.
Avoid ototoxic medications (drugs that can damage hearing) when possible, and discuss alternatives with your healthcare provider if you require potentially harmful drugs. Manage stress levels through relaxation techniques, adequate sleep, and work-life balance. Treat upper respiratory infections promptly and avoid aggressive nose-blowing that could damage inner ear structures.
Regular hearing assessments can establish baseline function and detect early changes. Quit smoking and limit alcohol consumption to support overall vascular health.
*Individual results and outcomes may vary.*
For Singaporeans & Singapore Permanent Residents
Medisave & Insurance Shield Plan approved
Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
How quickly do I need to seek treatment for sudden hearing loss?
Sudden hearing loss is a medical emergency requiring immediate evaluation, ideally within 24-48 hours of onset. Treatment effectiveness may decrease after 72 hours, and the benefit may be limited if treatment starts beyond two weeks. Even if symptoms seem mild or you hope they’ll resolve spontaneously, seek immediate medical attention. Early intervention with corticosteroids can help improve outcomes.
*Individual results and timelines may vary.*
What are my chances of recovering my hearing?
Recovery varies depending on severity, timing of treatment, and individual factors. Some patients may recover completely, others may experience partial improvement, and some may show no recovery. Factors that may influence prognosis include initial hearing loss severity, timing of treatment initiation, presence or absence of vertigo, and age. Patients with profound hearing loss or delayed treatment may have different recovery patterns. Your ENT specialist will discuss your specific situation based on your presentation and test results.
*Individual results and timelines may vary.*
Will the hearing loss affect both ears?
Sudden sensorineural hearing loss typically affects only one ear. Bilateral sudden hearing loss is less common but may be associated with autoimmune disorders, systemic diseases, or ototoxic medication exposure. If you experience hearing loss in both ears, seek emergency medical care immediately, as this may indicate an underlying condition requiring urgent evaluation.
Can stress cause sudden hearing loss?
While stress alone doesn’t directly cause sudden hearing loss, it may contribute as a risk factor. Stress levels can affect blood circulation, immune function, and may increase susceptibility to viral infections – all potential factors in sudden hearing loss development. Chronic stress may also affect tinnitus and recovery. Managing stress through appropriate techniques forms part of comprehensive treatment and prevention strategies.
What happens during intratympanic steroid injection?
The procedure is performed in the clinic. After applying a topical anaesthetic to numb the eardrum, your ENT specialist uses a thin needle to inject steroid medication directly into the middle ear space. You’ll lie on your side to allow medication absorption. Patients typically experience minimal discomfort, describing a sensation of fullness or slight pressure. Temporary dizziness may occur but typically resolves.
*Individual experiences may vary.*
Are there any restrictions after starting treatment?
During treatment, avoid exposure to loud noises and use ear protection when necessary. Flying is generally safe, but discuss with your specialist if you’ve had intratympanic injections. Avoid water entering the affected ear, especially after injections. Continue medications as prescribed, even if hearing improves. Limit strenuous activities if experiencing dizziness. Regular follow-up appointments are essential to monitor treatment response and adjust therapy as needed.
What if my hearing doesn’t fully recover?
Incomplete recovery doesn’t mean treatment failure, as even partial improvement can benefit quality of life. Modern hearing aids can help manage residual hearing loss, with options available for unilateral loss. Tinnitus management strategies, including sound therapy and counselling, can help address persistent ear ringing. Communication strategies and auditory training can help maximise remaining hearing. Your ENT specialist will work with audiologists to develop a comprehensive rehabilitation plan tailored to your needs.
*Individual results and outcomes may vary.*
Conclusion
Sudden hearing loss is a medical emergency that requires immediate attention and prompt treatment. While the experience can be distressing, early intervention with appropriate therapies may offer the potential for hearing recovery. Our ENT specialist has experience managing sudden hearing loss using evidence-based treatments tailored to each patient’s specific presentation. With comprehensive diagnostic capabilities and access to various treatment modalities, we aim to support your potential for hearing restoration and improve your quality of life.
*Individual results and timelines may vary.*
Take the First Step Towards Better Hearing
Living with hearing loss can be challenging, but you don’t have to face it alone. Our ENT specialist has experience diagnosing and treating hearing loss using evidence-based approaches.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
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Our Location
A Specialist Clinic for Sinus, Snoring & ENT
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Hospital
Singapore 329563
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