Sudden Hearing Loss: Treatment and Recovery Insights

Sudden Sensorineural Hearing Loss

Hello, Doctor.
On the morning of May 3rd, I woke up to find that my left ear felt stuffy and I couldn't hear very well.
That morning, I took two oral steroids and vitamin B, and in the evening, I took four steroids and B complex prescribed by National Taiwan University.
I underwent a hearing test that day, which showed a threshold of 65 decibels.
On May 4th, my left ear had significantly improved, and I could hear the phone ringing (I could hear it at just 20 decibels).
Coincidentally, the hospital where I work had an ENT department in the afternoon, so I quickly made an appointment and had another hearing test.
This time, the results showed that only one frequency was slightly impaired, but it was nearly back to normal.
I was very happy at that moment.
The attending physician assisted me in injecting intratympanic steroids (Rinderon 1ml).
I continued to take four steroids and B complex with every meal (but after the injection that evening, the feeling of fullness and pressure became more pronounced).
On May 5th, the day after the intratympanic steroid injection, I felt that my ear condition had returned to what it was on the day of onset...
I couldn't hear well again, but I followed the doctor's advice and continued taking high doses of steroids.
By the afternoon, the fullness and tinnitus increased, so I went to see a general ENT doctor.
The physician prescribed medication to promote blood circulation and advised me to continue taking the original steroids.
That day, I took 12 steroids along with blood circulation medication and B complex.
On May 6th (the third day after the intratympanic steroid injection), I returned for a follow-up at National Taiwan University, and the hearing test showed that I could only hear at 75 decibels.
The doctor indicated that the steroids I injected might not have been fully absorbed yet, which could be causing the fullness, or my condition might have worsened.
I would like to ask the doctor how long it typically takes for intratympanic steroids to be absorbed? Why did my hearing threshold change from being able to hear at 25 decibels orally to needing 75 decibels after the injection? (It has now been three days since the injection, and I am experiencing severe tinnitus and ear fullness.) Additionally, I mistakenly read the prescription and have been taking 12 steroids daily, but I actually only need to take 8.
Could this lead to a worsening of my hearing? I really don't know what to do, and I would appreciate your assistance in answering my questions.
Thank you.

Guo Xiaojie, 20~29 year old female. Ask Date: 2024/05/06

Dr. Zheng Jueyi reply Otolaryngology

Hello, both oral and injectable steroids are used to improve hearing.
Taking 12 steroid pills daily, as per the prescription, generally should not worsen hearing.
Currently, it is not possible to determine the cause of the hearing deterioration.
It is recommended to continue medication as prescribed and maintain regular outpatient follow-ups, allowing the clinician to assess the cause and determine further treatment options.

Reply Date: 2024/05/06

More Info

Sudden hearing loss (SHL) is a condition that can be alarming and distressing, as it often occurs unexpectedly and can significantly impact one's quality of life. Your experience highlights several important aspects of SHL, including treatment options, recovery potential, and the effects of medication.

Firstly, it’s important to understand that SHL can have various causes, including viral infections, vascular issues, autoimmune diseases, and even stress. In many cases, the exact cause remains unknown. The treatment typically involves corticosteroids, which are used to reduce inflammation and potentially restore hearing. Your use of oral steroids and intratympanic steroid injections is consistent with standard treatment protocols for SHL.
The fact that you experienced an initial improvement in hearing after starting treatment is encouraging. Many patients with SHL experience some degree of recovery, especially when treatment is initiated promptly. Studies suggest that about 60-70% of patients may see improvement, with a portion achieving complete restoration of hearing. However, the degree of recovery can vary widely among individuals.

Regarding your specific questions about the duration of steroid absorption and the effects of your medication regimen, it’s important to note that intratympanic steroid injections can take time to show their full effects. Typically, the steroids injected into the ear can take several days to be absorbed and exert their therapeutic effects. If you are experiencing increased ear fullness and tinnitus, it could be due to several factors, including the inflammatory response or fluid retention in the ear, which can occur after steroid injections.

As for the discrepancy in your hearing thresholds before and after the injections, it is not uncommon for patients to experience fluctuations in hearing during the recovery process. This can be influenced by various factors, including the body's response to treatment, the underlying pathology of the hearing loss, and even stress or anxiety related to the condition.

Regarding your concern about taking a higher dose of steroids than prescribed, it is crucial to adhere to the recommended dosage. While corticosteroids can be effective in treating SHL, taking them in excessive amounts can lead to side effects, including increased blood pressure, mood changes, and potential worsening of hearing issues. If you mistakenly took 12 tablets instead of 8, it’s advisable to consult with your healthcare provider immediately to discuss your symptoms and any potential risks associated with the higher dosage.

In summary, it’s essential to maintain open communication with your healthcare team. If you notice any worsening of symptoms or have concerns about your treatment plan, do not hesitate to seek further evaluation. Your healthcare provider can adjust your treatment based on your response and any side effects you may be experiencing. Additionally, consider discussing supportive therapies, such as sound therapy or cognitive behavioral therapy, which can help manage tinnitus and improve your overall well-being during this challenging time. Remember, early intervention and consistent follow-up are key to optimizing recovery from sudden hearing loss.

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