What Can Cause Single Sided Hearing Loss + Tinnitus?

[Hazel]

Hi there,

I've had tinnitus for nearly 4 weeks now. Mine is a high pitched ringing in my right ear only. Not very loud I suppose (although it doesn't always feel that way). As many of you have experienced, I went through extreme anxiety, sleeplessness etc. I seem to be getting a bit better now, had a full night's sleep last night!

Anyway, I decided to post my first thread with a specific question in mind, and hope to get some feedback from people with similar cases. I just had my audiogram done, and to my surprise it showed a 20 dB hearing loss in my right ear (same ear where I have T), across all frequencies. My left ear is perfect. The ENT also seemed surprised by this result; as he explained, hearing loss caused by noise exposure is typically two-sided; hence, the hearing loss must be caused by something other than noise exposure. [And in any case, I've not experienced any kind of acoustic trauma that I'm aware of.] He ordered an MRI to rule out acoustic neuroma. I am of course very nervous about this, and hope very much it's not that!

Causes that I've already ruled out (with the help of GP/ENT) are: ear infection (had the antibiotics anyway though, just in case), ETD (have used steroid nasal spray for 3 weeks now, no effect), blood pressure, medication, head/neck trauma, TMJ.

So my question is: what could be causing my single sided hearing loss and T? Assuming the MRI rules out AN of course... still have to wait two weeks for those results :-(

Hoping to hear from people with a similar T experience as mine. Any advice/insight would be much appreciated.

All the best to all of you....
H

 

[GregCA]

So my question is: what could be causing my single sided hearing loss and T? Assuming the MRI rules out AN of course... still have to wait two weeks for those results :-(

It could be mild Sudden SensoriNeural Hearing Loss (time is of the essence to treat that - every day matters!), it could also be otosclerosis (its presentation can be similar to SSNHL)...
Either way, don't wait!

 

[Hazel]

Hi Greg, thanks for your response. Can you tell me more about the treatment of SSNHL and why it's important to treat it quickly? My ENT did not mention this possibility, I guess he wants to rule out the neuroma first....

 

[GregCA]

Hi Greg, thanks for your response. Can you tell me more about the treatment of SSNHL and why it's important to treat it quickly?

Read more here.

My ENT did not mention this possibility, I guess he wants to rule out the neuroma first....

Perhaps, but by doing that he could be ruining your chances at recovering your hearing. If I were in your shoes, I'd go get a second opinion asap.

 

[dingaling]

A 20dB hearing loss is not SSNHL; in the UK at least, this is reserved for total hearing loss in one ear that is sensorineural in nature and comes on rapidly over the course of a few days

A 20dB hearing loss tells us absolutely nothing I'm afraid. Don't know your history, is there any pathology such as blockage? Is the hearing loss conductive in nature or sensorineural? Could be audiometric/technician error , could be any number of possibilities. You need to give us a bit more information

 

[Tinker Bell]

A 30dB drop across three frequencies is the common guideline for diagnosing SSNHL according to the ear specialists that I have seen. However, there are always exceptions.

I have sudden hearing loss in only my right ear, and the likely cause was a viral cold that I had in the month leading up to my hearing loss. I thought it was a simple cold, but I have now learned that even minor viruses can do significant damage. Not everyone's immune system has the same reaction to the same virus.

Another possibility is autoimmune disorders. There are some that can cause one-sided hearing loss.

In case the cause is viral or autoimmune, you need to act quickly and should ask your doctor about oral steroids or possibly even intratympanic steroid injections. The thought with viruses and autoimmune disorders is that inflammation is damaging the auditory nerve. Steroids work to reduce the inflammation, which can help either stop additional damage or help recover some hearing.

 

[GregCA]

A 20dB hearing loss is not SSNHL; in the UK at least, this is reserved for total hearing loss in one ear that is sensorineural in nature and comes on rapidly over the course of a few days

The definition of SSNHL is 30 dB loss in 3 consecutive frequencies (per PTA). However, if it was me and I had 20 dB losses all of a sudden across all frequencies, I'd strongly consider the same treatment as SSNHL, even if - technically - it is not considered SSNHL. I care more about my hearing than the name of the diagnosis.

Is the hearing loss conductive in nature or sensorineural?

This is important to know indeed. Rinne/Weber test outcomes, etc.

Could be audiometric/technician error , could be any number of possibilities.

Yup, that's why I'm suggesting another opinion/data point quickly.

 

[Tinker Bell]

The definition of SSNHL is 30 dB loss in 3 consecutive frequencies (per PTA). However, if it was me and I had 20 dB losses all of a sudden across all frequencies, I'd strongly consider the same treatment as SSNHL, even if - technically - it is not considered SSNHL. I care more about my hearing than the name of the diagnosis.



This is important to know indeed. Rinne/Weber test outcomes, etc.



Yup, that's why I'm suggesting another opinion/data point quickly.

Right. My hearing loss pattern did not match SSNHL with initial tests. It was a very large loss, but in two consecutive frequencies. My doctors still treated it and classified it as SSNHL.

Later tests above 8k very clearly indicated that I had lost far more than two frequencies, and we even that there was loss in a third lower frequency.

I did not regain my lost hearing despite steroids, but I still do not regret doing everything I could to at least try.

 

[dingaling]

@HazC

Can you give us a little more information? Did you notice a subjective loss of hearing over time or was it sudden (or over a few days)? Did/does it fluctuate? Any feeling of pressure? Any distortion of hearing? Did you have a tympanogram? Were you unwell at the time? Have you a copy of the audiogram? Any history of ear disease?

These are a few of many questions that would need to be answered before anyone can give any reasonably accurate thoughts? And of course, only a qualified ENT will be able to diagnose the specific cause.

 

[Hazel]

Thanks to all for your advice! I'll ask my GP tomorrow about steroids/cortisone treatment.

Regarding your question: The audiologist and ENT had different opinions as to which type of hearing loss I have. The audiogram showed conductive hearing loss, i.e. the loss was only present with sound transmitted into my ear, not with sound transmitted through the bone. However, my ENT felt this should be a false result, because it contradicts the Rinne/Weber test he performed, and because he cannot see any obstruction in the outer or middle ear. Such a false result can apparently occur when the bone of the head conducts the sound to the other side of the head so that it's heard in the ear that does not have hearing loss.

Another uncertainty that the ENT mentioned is that perhaps what seems like a 20 dB loss is actually (in part) due to the tinnitus itself, i.e. I couldn't hear the beeps from the test because my T was interfering. However, this seems to me unlikely to occur accross all frequencies.

 

[Hazel]

@HazC

Can you give us a little more information? Did you notice a subjective loss of hearing over time or was it sudden (or over a few days)? Did/does it fluctuate? Any feeling of pressure? Any distortion of hearing? Did you have a tympanogram? Were you unwell at the time? Have you a copy of the audiogram? Any history of ear disease?

These are a few of many questions that would need to be answered before anyone can give any reasonably accurate thoughts? And of course, only a qualified ENT will be able to diagnose the specific cause.

I actually did not consciously notice my hearing loss at all! I only noticed my T. Now that I have the audiogram results, I can notice when for instance playing a sound from my phone and putting it first next to one ear and then the other, that my right ear does have some loss. So it seems to be real, I just never noticed it before. So I also don't know whether it came on suddenly or not, although I assume it came on at the same time as the T.

I do feel some pressure on my ear, i.e. a 'fullness'. No hearing distortion, recent illness or history of ear disease,

I still have to get the tympanogram. My ENT did not propose it, but I'll make sure to get it one way or the other.

 

[dingaling]

I actually did not consciously notice my hearing loss at all! I only noticed my T. Now that I have the audiogram results, I can notice when for instance playing a sound from my phone and putting it first next to one ear and then the other, that my right ear does have some loss. So it seems to be real, I just never noticed it before. So I also don't know whether it came on suddenly or not, although I assume it came on at the same time as the T.

I do feel some pressure on my ear, i.e. a 'fullness'. No hearing distortion, recent illness or history of ear disease,

I still have to get the tympanogram. My ENT did not propose it, but I'll make sure to get it one way or the other.

Are you able to post the audiogram results?

 

[GregCA]

However, my ENT felt this should be a false result, because it contradicts the Rinne/Weber test he performed, and because he cannot see any obstruction in the outer or middle ear.

I think that's a good reason why you need more data: you've got inconsistent results right now.
BTW, my otosclerosis was first diagnosed as SSNHL, as the conductive losses didn't show up on tests until about 6 weeks later.

 

[Red]

I don't think it has to be anything special. I have tinnitus in my left ear and I have no doubt that it was from loud noise. Even before tinnitus, I knew that there were hearing differences in my ears. As long as it is not a huge gap, being asymmetrical is normal. I think it is also possible if you had a noise exposure that came from the East or West of you.

 

[Philippe79]

My ENT did not mention this possibility, I guess he wants to rule out the neuroma first....

Perhaps, but by doing that he could be ruining your chances at recovering your hearing. If I were in your shoes, I'd go get a second opinion asap.

Take 'GregCA's advice.. This is the mistake I made, I shouldn't have accepted this... I had to wait four months for my MRI scan results (to rule out an acoustic neuroma). During this period, time was wasted and I could be paying the price. The amount of urgency shown in my case was well and truly shambolic.

 

[Codaz]

A 30dB drop across three frequencies is the common guideline for diagnosing SSNHL according to the ear specialists that I have seen. However, there are always exceptions.

I have sudden hearing loss in only my right ear, and the likely cause was a viral cold that I had in the month leading up to my hearing loss. I thought it was a simple cold, but I have now learned that even minor viruses can do significant damage. Not everyone's immune system has the same reaction to the same virus.

Another possibility is autoimmune disorders. There are some that can cause one-sided hearing loss.

In case the cause is viral or autoimmune, you need to act quickly and should ask your doctor about oral steroids or possibly even intratympanic steroid injections. The thought with viruses and autoimmune disorders is that inflammation is damaging the auditory nerve. Steroids work to reduce the inflammation, which can help either stop additional damage or help recover some hearing.

Can they test such virusses?

 

[Tinker Bell]

Can they test such virusses?

They can check for autoimmune diseases and some viruses, but not all viruses can be identified with testing. Sometimes viruses attack, damage the body, and leave. In those cases, there is no lingering identifying factor left in the body.

And sometimes viruses cannot even be identified while they are attacking. Blood work will indicate the body is fighting off something, but it's not possible to identify what.

 

[Codaz]

They can check for autoimmune diseases and some viruses, but not all viruses can be identified with testing. Sometimes viruses attack, damage the body, and leave. In those cases, there is no lingering identifying factor left in the body.

I had a sudden T increase attack last week. Major one. Now I'm on oral prednisone and my T is down to a low hum. But I lost -40 dB in 250 and 500 hz. I'm doubting where it came from. ENT only shined a light in my ear and said "don't know".

 

[Tinker Bell]

I had a sudden T increase attack last week. Major one. Now I'm on oral prednisone and my T is down to a low hum. But I lost -40 dB in 250 and 500 hz. I'm doubting where it came from. ENT only shined a light in my ear and said "don't know".

To clarify, was the loss in only one ear?

Any illness — even minor — in the last two months?

 

[Codaz]

To clarify, was the loss in only one ear?

Any illness — even minor — in the last two months?

Only some watery nose. Yes one ear loss.

My facial pain spread to my left ear last year (see facial pain thread) and that's when I noticed some loss in bass tones. Last wednesday I woke up with little to no hearing in that ear and ran to the ER to get prednisone. Now the insanely loud beep is gone but I don't like the hearing loss.

ENT said: dunno. She didn't knew anything about the relationship between TMJ - Facial pain and T. So in best case it was just a TMJ attack, in worst case it was something different. She only shined a light into the ear and that was it.

 

[Pcam1988]

I can relate to this story. I think I had a virus whilst on holiday which led me to have a headache on the right side of my head and T in my right ear. Went to the ENT who checked my ears and tubes and said they were fine. Went for the hearing test and found that I have high frequency loss in my right ear (4K 40db to 8k 60db). I've just finished the predisone recently which did nothing for me. Crazy how this can happen over a simple virus, my hearing was fine before this. My left ear is perfectly normal I just have the ringing in my right ear. I don't have any other symptoms as my virus had cleared up after a week a just left me with my ringing in the ear. I find listening to white noise helps me concentrate so I'm going down the road of trying a hearing aid with a permanent masker in it which will hopefully help me habituated to it. I don't no if I should go down the mri route yet as I don't have any dizziness or loss of balance. Just got to treat it as one of life's problems. I still hear fairly normally in my right ear. Just require something to mask the noise.

 

[Codaz]

I can relate to this story. I think I had a virus whilst on holiday which led me to have a headache on the right side of my head and T in my right ear. Went to the ENT who checked my ears and tubes and said they were fine. Went for the hearing test and found that I have high frequency loss in my right ear (4K 40db to 8k 60db). I've just finished the predisone recently which did nothing for me. Crazy how this can happen over a simple virus, my hearing was fine before this. My left ear is perfectly normal I just have the ringing in my right ear. I don't have any other symptoms as my virus had cleared up after a week a just left me with my ringing in the ear. I find listening to white noise helps me concentrate so I'm going down the road of trying a hearing aid with a permanent masker in it which will hopefully help me habituated to it. I don't no if I should go down the mri route yet as I don't have any dizziness or loss of balance. Just got to treat it as one of life's problems. I still hear fairly normally in my right ear. Just require something to mask the noise.

The prednisone definately did something but I wonder how much.

 

[Pcam1988]

Nothing of note apart from giving me sleepless nights

 

[Codaz]

Nothing of note apart from giving me sleepless nights

Prednisone should be taken on mornings for best results. Don't ask me why.

 

[Tinker Bell]

Prednisone should be taken on mornings for best results. Don't ask me why.

My dosage was multiple pills taken throughout the day. It is a common side effect for prednisone to cause sleep problems, regardless of when you take it.

 

[CCsMom14]

Same story - same time frame. No results (maybe worse after steriods). Will have an MRI - but honestly doing lots of research myself. I suspect a virus that will take time - meanwhile beefed up my vitamins and lots of water. Melatonin helps to sleep and a cotton ball to reduce any more irritation to the nerve. Stay in touch.

Lori

 

[Pcam1988]

Yeah am waiting to do an mri also but I don't think it will show anything up as I don't have any other symptoms. It's very frustrating. I can still hear fairly wel out of the right ear but the constant buzz drowns things out. I'm going down the route of getting a hearing aid. I no I haven't had it long and it takes time to settle but I'm impatient, if there is something I can do now to ease the condition I'm doing it.

 

[CCsMom14]

@Pcam1988 - sounds like we are in the exact same boat. I am just not experiencing the other symptoms that would warrant an MRI - plus the fact that the ENT visit I had on Monday, the DR did not even examine me. I am starting to suspect the viral infection has caused some interaction with my Type 2 Diabetes and for some reason the nerves in my inner ear are really irritated. I am going to wait a full 48 hours after I am completely off this Prednisone (last day today) and see how I feel -

I still experience a popping sensation in that ear. The fact that I have TMJ on that side may also play a factor - so really just a waiting game. I share your frustration -

 

[Pcam1988]

I don't have any underlying problems at all. I was fit and healthy until 4 weeks ago after a trip away, genuinly thought it was a simple bug. I had the bug and took ibruprofen and paracetamol given to me by the doctor, I don't no if these impacted on my hearing or not. The ENT checked my ears and put a camera up my nose and said everything was fine. I don't want to take that predisone ever again, made me feel constantly fatigued and didn't help my ringing. I'm hopeful I can habituate to it in time as I can still hear relatively well although I finding masking it better than just listening to the buzz.

 

[Hazel]

@Pcam1988 and @CCsMom14 , thank you both for your replies. Your cases sound similar to mine, so let's keep each other posted. I just started following both of you in order to stay in touch easily.

I suppose my one-sided hearing loss and tinnitus could also be caused by a virus. I haven't felt ill though, just a slight cold just prior to onset of the T. And a few months previous to onset, I had these strange piercing head aches on the right side of my head (same side as hearing loss and T) for about one week.

My ENT also mentioned the possibility of Lyme disease. I did have a tick bite over a year ago, so I suppose it's possible.

I will get the results of my MRI next week; which the ENT seemed to think was warranted even though just like you I don't have any other symptoms. Assuming this does not show anything, I'll start exploring further options.