{"id":74846,"date":"2024-03-25T15:07:25","date_gmt":"2024-03-25T21:07:25","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=74846"},"modified":"2024-03-25T15:07:25","modified_gmt":"2024-03-25T21:07:25","slug":"sudden-hearing-loss-needs-to-be-addressed-as-soon-as-possible","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/sudden-hearing-loss-needs-to-be-addressed-as-soon-as-possible\/","title":{"rendered":"Sudden hearing loss needs to be addressed as soon as possible"},"content":{"rendered":"
<\/div>
\"Andy
Andy Strunk listens to his son, Ben, 3, explain his approach to slicing strawberries as Zach, 6, chops up broccoli. They use special kids\u2019 safety knives and like to help make dinner. Photos by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

On a July day last summer, Andy Strunk awoke to an inexplicable condition: the hearing in his left ear was gone.<\/p>\n

A rapid onset of any condition can make a person spin with worry, and Strunk was no different. He wondered: \u201cIs there something bigger going on? Is something not good in my brain? Did I do something wrong? Have I had a stroke?\u2019\u2019<\/p>\n

Sudden hearing loss is not uncommon with about 1 in 5000 people per year experiencing sudden hearing loss in one or both ears. In many cases, many individuals do not consider this an emergency medical condition, but urgent treatment is critical.<\/p>\n

Seek treatment for sudden hearing loss<\/strong><\/h2>\n

\u201cIt\u2019s common for these patients to miss the treatment window because they may delay care assuming that symptoms will self-resolve,\u201d Dr. Ashley Nassiri<\/a>, an Ear, Nose and Throat<\/a> (ENT) doctor who specializes in ear, hearing and skull-base surgery (Otology & Neurotology). She works at UCHealth Ear, Nose and Throat Clinic – Anschutz Medical Campus<\/a>.<\/p>\n

\u201cAn important point for these patients is that the sooner you can get treatment, the higher the chance is that treatment will be effective. We consider sudden sensorineural hearing loss urgent and want to test patients within 3 days of the onset of hearing loss.\u201d<\/p>\n

Fortunately, Strunk, the father of two young boys, did not wait to seek medical help. He sent a message through My Health Connection, UCHealth\u2019s patient portal, to Dr. Brad Changstrom<\/a> at the UCHealth Internal Medicine Clinic \u2013 Lowry<\/a>.<\/p>\n

\u201cHey \u2026.\u2019\u2019 Strunk began in his note, explaining that his hearing had vanished in the left ear. \u201cIt\u2019s not getting any better. What should I do? Should I come see you? Or what\u2019s next?\u2019\u2019<\/p>\n

\"Ben
Ben Strunk insists that his dad taste a strawberry during dinner preparation.<\/figcaption><\/figure>\n

The same day, Changstrom responded: \u201cThis is highly worrisome to me. You need to see audiology for a hearing test and ENT in the next 24-48 hours. There is risk of permanent hearing loss even with the early treatment.\u201d<\/p>\n

\u201cI am having a nurse call the ENT clinic to try to help get you scheduled. If you can\u2019t get in there within the next 24 hours, please let me know. In the meantime, I am starting a high dose steroid medication until you see them.\u2019\u2019 Changstrom wrote.<\/p>\n

Changstrom, who is the team physician for the Colorado Avalanche, has since moved from Lowry to UCHealth Foot and Ankle Clinic \u2013 Boulder, where he is a primary care sports medicine doctor. He said nurses at Lowry helped get Strunk in to see Nassiri, who is also an Assistant Professor<\/a> of Otolaryngology at the CU School of Medicine.<\/p>\n

\"Dr.
Dr. Ashley Nassiri<\/figcaption><\/figure>\n

Strunk was grateful for the quick reply. The father of two boys, ages 3 and 6, relishes the conversations he has with his sons when they cook dinner after he gets off work at a technology company that builds software for clinicians to reduce waste using technology in medical settings. Full of life, the boys are eager to learn, no matter if they\u2019re learning to prepare a meal, skiing Colorado\u2019s Rocky Mountains or studying how to speak Mandarin.<\/p>\n

Strunk purchased kid-safe chef\u2019s knives for the boys so they can assist in chopping the onions and cucumbers. As they prepare the meal, Strunk introduces a bit of a chemistry lesson, pointing out temperature and the size of the vegetables, why an onion that is diced instead of minced will cook differently under different temperatures.<\/p>\n

\u201cDaddy, is this the right size? When do we put this in? Is the temperature right,\u2019\u2019 Zach asks.<\/p>\n

Hearing their voices clearly is something Strunk never doubted until he woke up that morning last summer.<\/p>\n

\u201cBasically, the hearing was just gone,\u2019\u2019 Strunk said.<\/p>\n

Idiopathic sudden sensorineural hearing loss<\/strong><\/h2>\n

The day after his note to Changstrom via My Health Connection<\/a>, Strunk was in Nassiri\u2019s office.<\/p>\n

\u201cShe is just the person that I needed,\u2019\u2019 Strunk said.<\/p>\n

Nassiri put a name to Strunk\u2019s condition: Idiopathic sudden sensorineural hearing loss. That means that doctors don\u2019t know what caused the hearing loss, though the leading theory is that it could have been caused by a viral infection or loss of blood flow to the inner ear.<\/p>\n

\u201cThe leading theory is that either inflammation or lack of adequate blood flow to the cochlea, the hearing instrument of the inner ear, causes a sudden onset hearing loss,\u201d Nassiri said. \u201cGenerally, our main treatment option is steroids, which broadly reduce inflammation.\u2019\u2019<\/p>\n

\"Andy
Andy Strunk points out the sudden flight of geese from the Great Lawn Park Lake as Zach rides up on his bike.<\/figcaption><\/figure>\n

Strunk remembered Nassiri\u2019s candor when she told him that Changstrom did the right thing prescribing steroids and that he would know in about 3-6 months how much hearing he would recover.<\/p>\n

\u201cIt was scary news, but I was glad she was so blunt,\u2019\u2019 Strunk said.<\/p>\n

There are two ways to deliver steroids to the inner ear. One route is oral steroids, and Strunk was already taking steroids with the hope that the drug would eventually reach the bloodstream and circulate through the cochlea to have its effect.<\/p>\n

Nassiri also offered a second route, via an injection of liquid steroid through the ear drum. The idea is that this liquid steroid sits in the middle ear and diffuses into the cochlea though a small membrane called the round window. In this in-clinic procedure, the ear drum is anesthetized with numbing medicine and a small needle is used to inject the steroid into the middle ear. In addition, she ordered an MRI for Strunk, to rule out any tumors or other inner ear abnormalities that could explain a sudden hearing loss.<\/p>\n

\u201cSo what happens is, you lie on your side for about 30 minutes and you marinate your cochlea \u2013 I\u2019m not sure what the medical term is for it, other than that. But what she did is she placed a liquid steroid and said, \u2018this is just going to bathe your cochlea for the next few days and we hope it will help with reduction of inflammation.\u2019\u2019<\/p>\n

\"Zach,
Zach, 6, and Ben, 3, have juice to get their energy levels up before a bike ride in Lowry neighborhood\u2019s Great Lawn Park with their dad, Andy.<\/figcaption><\/figure>\n

By the time Strunk returned for a follow-up visit with audiology, his hearing had been restored. Nassiri said that she does not know for certain what caused the sudden hearing loss. And while data suggests that steroids improve rates of hearing recovery, some people recover on their own.<\/p>\n

\u201cI was kind of excited with the outcome,\u2019\u2019 Strunk said. \u201cThe fact that she was like, \u2018you\u2019re going to know in 3-6 months what you\u2019re going to have for the rest of your life, I was expecting it not to return. So with all the steroids and the quick interventions, and the coordination between primary care and specialty care, and given that speed and access to specialty care, all of the right protocols resulted in a really good outcome.\u201d<\/p>\n

\u201cI haven\u2019t had any problems since. I\u2019m able to fly, I\u2019m able to swim and I\u2019m able to do everything like I used to,\u2019\u2019 he said.<\/p>\n

Urgent treatment for sudden hearing loss is critical<\/strong><\/h2>\n

For anyone experiencing sudden hearing loss, Nassiri said, time is of the essence.<\/p>\n

\u201cThe sooner you get a formal hearing test and treatment if indicated, the better,\u2019\u2019 she said. \u201cReally, if you are beyond eight weeks from the onset of sudden hearing loss, there is no evidence to support efficacy of steroid treatment at that point. Beyond two months, I generally do not recommend steroid treatment because the risks outweigh the potential benefits,\u2019\u2019 she said.<\/p>\n

\"Dr.
Dr. Bradley Changstrom<\/figcaption><\/figure>\n

Getting a formal hearing test (audiogram) completed within 72 hours of the onset of sudden hearing loss is ideal.<\/p>\n

\u201cIt is important for primary care doctors to pick up on this and for patients to advocate for their care. We have a protocol in our office that if a patient, primary care doctor, or other physician calls with concerns for a sudden hearing loss, we get them in for a hearing test within 72 hours. We consider it an \u2018ear emergency.\u2019\u201d<\/p>\n

\u201cIf a person demonstrates sensorineural hearing loss on the hearing test, then they see us almost immediately. That is the internal protocol that we have standardized,\u2019\u2019 Nassiri said. \u201cThe level of urgency is not something that is well-known in the general population, and we are trying to get the word out about it.\u2019\u2019<\/p>\n

Another detrimental factor is that tinnitus \u2013 ringing sound heard in the ears \u2013 often accompanies sudden hearing loss, \u201cand that can have a major impact on quality of life. Tinnitus is another diagnosis that we co-manage with the hearing loss,\u2019\u2019 Nassiri said.<\/p>\n

When people don\u2019t recover their hearing, they can consider a hearing aid or a cochlear implant, depending on the level of hearing loss.<\/p>\n

Fortunately, Strunk\u2019s hearing has been restored. He is more than grateful for the coordination of care between Changstrom and Nassiri.<\/p>\n

\u201cI’m really glad that his hearing issues resolved,\u2019\u2019 Changstrom said.<\/p>\n

For Strunk, there\u2019s nothing better than hearing the sound of his sons\u2019 voices as they banter back and forth while cooking a nice meal.<\/p>\n

No matter what they are making, the question Strunk knows he’ll always hear: \u201cDad, when is going to be time to eat?\u2019\u2019<\/p>\n","protected":false},"excerpt":{"rendered":"

On a July day last summer, Andy Strunk awoke to an inexplicable condition: the hearing in his left ear was gone. A rapid onset of any condition can make a person spin with worry, and Strunk was no different. He wondered: \u201cIs there something bigger going on? Is something not good in my brain? Did […]<\/p>\n","protected":false},"author":20,"featured_media":74849,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[9129,9138,1112,3474],"class_list":["post-74846","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-conditions-and-treatments","tag-ear-nose-and-throat-care","tag-ear-nose-throat-care-otolaryngology","tag-hearing-loss-care-audiology"],"acf":[],"yoast_head":"\nSudden hearing loss needs to be addressed as soon as possible - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Sudden hearing loss is an urgent medical issue. 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