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Dr. Denis Grillo, Ear, Nose & Throat, 7/8/14

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Idiopathic sudden sensorineural hearing loss

By Dr. Denis Grillo

Idiopathic sudden sensorineural hearing loss is a type of hearing loss that affects the hearing nerve. There is nothing physically wrong with the ear and we use the term idiopathic, which means unknown cause, because it is quite controversial. 

Various theories have been presented and include a viral infection of the inner ear, diminished blood flow to the inner ear by spasm of the artery or a cholesterol plaque or a blood clot. 

There can also be damage to the inner ear that we cannot see or a leak of inner ear fluid and, in some instances, it can be genetic or related to autoimmune disease and, as of late, we are starting to see another possible cause and that is hyperglycemia or high blood sugars. 

As we know, high blood sugar — also known as diabetes — is on the uptick because of poor dietary habits and obesity. I think most people are familiar with diabetic problems related to the eyes and the feet, but do not think about how it can affect other nerves such as the hearing nerves, but this is a new theory that seems to be grabbing the attention of doctors and scientists. 

Sudden sensorineural hearing loss, in general, affects about five to 20 people per 100,000. It is defined as approximately a 30 percent drop in hearing suddenly in three speech frequencies and usually occurs within 24-72 hours. There are some factors that do affect the outcome and resolution. This includes age, younger obviously being better at healing and if there is some presence of dizziness and also when the event is diagnosed and treated (the sooner the better).

Type 2 diabetes, which is adult onset diabetes, is the one that is starting to become more common and seen more frequently because of our diet and lifestyle. It has a potential effect of damaging the hearing more so because of the fact that it hits older patients who could already be compromised because of age and/or previous noise exposure in work or military settings. High blood sugar levels can cause damage to the blood vessels going to the ear the same way it affects and damages blood vessels in the eyes and the extremities (feet most commonly). Increased thickness of blood and clotting and blockage of these vessels also can cut the blood supply to the inner ear and result in damage and sudden hearing loss. 

Spontaneous recovery from this type of hearing loss varies greatly and is difficult to predict. There can be no recovery, partial recovery or complete recovery. Some of our patients have what I would call a triple threat; not only do they have diabetes, but they also have high cholesterol levels and hypertension. The three combined will slow hearing recovery and could ultimately affect the outcome. 

Treatment is typically the use of steroids, which in a diabetic patient can pose a risk and necessitate the primary care or internal medicine doctor to work with the ENT doctor to control the blood sugars, which could be affected by taking the steroids, as steroids can elevate the blood sugar levels. In addition, injection of steroids through the eardrum is also used and if oral steroids do not work.

Despite years of research and experimentation, sudden sensorineural hearing loss related to diabetes and other causes still remains somewhat of a mystery and is difficult to treat and get consistent good outcomes. Needless to say, a healthy diet and lifestyle will most certainly help you avoid a sudden sensorineural hearing loss related to type 2 diabetes.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.