Acute hearing loss
Synonym in a broader sense
Medical: hypacusis
Deafness, deafness, conductive hearing loss, sensorineural hearing loss, inner ear hearing loss, hearing loss, hearing loss, sudden hearing loss
Definition of hearing loss
Deafness (hypacusis) is a reduction in hearing that can range from mild hearing loss to complete deafness.
Hearing impairment is a widespread condition that occurs in both young people and more often in old people. In Germany around six percent of the population is affected by hearing loss. It is noticeable that the age at which hearing loss occurs is decreasing. Naturally, however, the hearing loss only progresses with increasing age.
One only becomes aware of a decrease in hearing when familiar noises, sounds and voices are suddenly no longer perceived or understood. The hearing loss usually occurs gradually and can be perceived as a significant disability if the damage has already occurred.
The focus is not so much on the therapy of hearing loss, but rather on prevention at a young age. There are many preventive measures that can be taken to preserve our hearing. There are legal regulations in the workplace, according to which you are not allowed to expose yourself to a volume of more than 85 decibels (dB) without hearing protection, but this limit is reached especially in leisure time. Discos, rock concerts, loud music through headphones, car races, etc. generate such noise that can in the long term damage your hearing inexorably.
emergency
Acute hearing loss develops quickly and is usually reported by the patient. clearly perceived and is always considered an emergency!
An ENT doctor should be consulted immediately in the event of sudden hearing loss or hearing loss.
causes
How does acute conductive hearing loss occur and how is it treated?
Ear wax (cerumen) and foreign body in the outer Ear canal
Ear wax, dust and bits of skin are natural in the external auditory canal and are usually transported to the outside or washed out while showering.
Excessive accumulation or formation of Ear wax (Cerumen), however, occurs more often in narrow ear canals or when working in dusty conditions.
Attempting to remove the wax with chopsticks unfortunately leads to that even more towards you eardrum and the ear canal continues to clog.
Other foreign bodies such as cotton residue can increasingly block the ear canal. Children sometimes run the risk of getting caught in small objects while playing ear stuck without the parents having noticed.
About a Otoscope These foreign bodies or ear wax become visible (ear mirror) and can be removed by the family doctor with small instruments.
If a mechanical removal should not succeed, the ear wax (cerumen) or the foreign body is rinsed out with water.
Inflammation of the external ear canal (otitis externa)
The outer ear canal can be infected by bacteria, viruses, Mushrooms or ignite in case of allergies. The swelling can block the ear canal so much that it can lead to hearing loss (hypacusis).
Antibiotic (bacteria), antifungal (fungi), or anti-inflammatory treatments will quickly reduce the swelling.
Eardrum injury (tympanic membrane rupture)
Manipulating the external auditory canal, for example by inserting an ear swab too far or hitting the ear with the flat of the hand, can damage the eardrum.
In addition to pain and a small amount of bleeding, there is a reduction in hearing. The ear, nose and throat specialist tries to close the crack with a fine seam. Small damage also heals by itself.
Tube ventilation disorder (tube catarrh)
At Inflammation in the nasopharynx (pharyngitis, sinusitis = Sinus infection, acute rhinitis (sniff)) the mucous membrane can swell to such an extent that the Eustachian tube (Tuba Eustachii) no longer for a pressure equalization between the Middle ear and can take care of the throat.
Especially with pressure fluctuations (diving, flying, mountaineering), an uncomfortable pressure is felt in the ear, which no longer disappears even when swallowing and yawning. In addition, there is a hearing loss that only stops when the pressure is equalized.
Acute tube ventilation disorders usually heal by themselves due to a banal viral infection. Decongestant nasal drops can cause decongestion and reopen the Eustachian tube. A puncture (paracentesis) of the eardrum to drain one is rarely necessary Tympanic effusion necessary.
Acute otitis media acuta
Acute otitis media is an infection of the lining of the middle ear, either caused by viruses or bacteria. Usually one speaks of an ascending infection, since the pathogens usually originate from the nasopharynx and previously a cold (rhinitis), an inflammation of the sinuses (sinusitis) or bronchitis prevailed. The pathogens find their way through the ear trumpet (Eustachian tube, auditory tuba), which connects the middle ear with the nasopharynx. Children are particularly often affected by such infections and then complain of throbbing, pulling earaches, which are also accompanied by fever and hearing loss. General rest and decongestant nasal drops can quickly lead to recovery from viral infections. In the case of bacterial infection, the symptoms should be treated with an antibiotic. Children who have a noticeably frequent otitis media should generally be examined by an ENT doctor, as special causes (polyps, chronic tonsillitis), chronic pharyngitis (angina), chronic sinus infections (sinusitis) may be the cause.
You can find further information under our topics:
- acute otitis media
- Sinus infection
- sniff
Pressure injury to the ear (barotrauma)
In the event of sudden changes in pressure (diving, flying, mountain climbing), a pressure difference builds up between the middle ear and the external auditory canal.
This is quickly compensated for by a healthy ear trumpet. If the eustachian tube is severely impaired and there is a particularly rapid change in pressure, the eardrum is stretched too much. We perceive this as a feeling of pressure and hearing loss. It can even tear if placed under excessive pressure, causing severe earache, ringing in the ears, and hearing loss.
A tear in the eardrum can be sewn up again with a small operation.
Ossicular dislocation
The three ossicles (Hammer, anvil and stirrup) transmit the sound from the eardrum to the Inner ear.
Like all other joints, they have a connection via connective tissue and ligaments, which are very susceptible to violence. It is true that the joints between the auditory ossicles cannot be injured directly, but with strong force on the skull. Accidents, Falls and boxes can interrupt the connection between the individual ossicles. There is a dislocation (dislocation) and one acute hearing loss. Surgical therapy (tympanoplasty, see below) can lead to improvement.
Skull fracture (skull base fracture)
If with one Skull fracture the fracture line runs directly through the middle ear (longitudinal pyramidal fracture), this can affect the auditory nerves (Vestibulocochlear nerve) damage.
In addition, the blood that emerges from the fracture can flow into the middle ear and impair sound transmission through the ossicles (hematotympanum). Surgical therapy is essential for severe fractures.
The therapy is interdisciplinary, i.e. the specialist in ear, nose and throat medicine works together with the specialist in neurology, the neuroradiologist and a neurosurgeon.
therapy
How does one come about acute Sensorineural hearing loss and how is it treated?
- Sudden hearing loss (acute hearing loss, Angina pectoris of the inner ear, English: sudden deafness, apoplectiform deafness)
The sudden hearing loss is a sudden, mostly unilateral hearing loss. - Noises in the ears (Tinnitus) and a cotton-like feeling of pressure can also occur. A cause is rarely found, but is usually localized Circulatory disorder in the inner ear explained.
- Many underlying diseases (e.g. high blood pressure, Heart failure = Heart failure) can promote sudden hearing loss and must be taken into account during therapy.
Infusion treatment is the main therapy today.
The so-called hydroxyethyl starch solution (HAES) improves the flow properties of the blood. This effect is reinforced by the addition of drugs that promote blood circulation. An underlying condition such as high blood pressure should definitely be treated and stress, nicotine (Smoke) and avoiding excessive coffee consumption. - Noise pollution
Loud noise, such as that generated in noisy discos or by jet engines, can lead to acute hearing loss. Ringing in the ears, Dizziness and a feeling of pressure in the ear can accompany the hearing loss. A longer break in a quiet environment, wearing hearing protection and earmuffs can help in the future. - Infections of the inner ear
Viruses and bacteria can acutely infect the inner ear and contribute to hearing loss. Most of the time it is infections that are spread from the meninges (meningitis) or one Shingles at the ear (Herpes zoster oticus).
Also mumps -, Scarlet fever -, typhus - and Lyme disease Pathogens can spread to the inner ear.
Treatment is carried out on the one hand with high doses of antibiotics or virus statics and on the other hand anti-inflammatory drugs (Cortisone). - Drug poisoning (ototoxicosis)
Some Medication have the undesirable side effect of inner ear damage dizziness and causing tinnitus.
The inner ear damage, however, depends on the amount of the respective drug and occurs rather rarely with controlled administration. These drugs include Aminoglycoside group antibiotics (Gentamicin), Diuretics (Furosemide, trade name: Lasix®) and some Cytostatic agents (Drugs used to treat cancer).
If drug-related inner ear damage occurs, the drug must be discontinued, because the damage is reversible, especially at the beginning. - Environmental toxins
- Skull fracture (Skull base fracture)
In the case of a fractured skull, the fracture line can run through the ear parts. If the fracture line lies in the area of the inner ear (pyramidal transverse fracture), acute hearing loss, dizziness and possibly partial facial paralysis (facial paralysis) occur. The treatment depends on the extent of the break and is carried out by a team of doctors from ENT, neurology and radiology. - Skull injury (blunt skull trauma, labyrinth concussion, commotio labyrinthi)
Even if the force was not applied directly to the ear, a damaging pressure wave can be transmitted to the inner ear via the ossicles. The symptoms are varied and are associated with severe hearing loss, dizziness, a feeling of pressure and tinnitus.
Depending on the extent of the injury, conservative or surgical therapy is sought. - Crack of the oval and / or round window
The middle ear (tympanic cavity with auditory ossicles) is connected to the inner ear (cochlea and semicircular canals) via two thin skins (membranes; round and oval windows). These membranes can be damaged by accidents, noise, operations on the ear, pressure and tumors. Typical symptoms are changeable hearing, dizziness, tinnitus and ear pressure. - Meniere’s disease; Meniere's disease
This disease predominantly affects middle-aged men. It is noticeable that it often occurs in vegetatively unstable patients after psychological stress, weather changes, alcohol, caffeine and nicotine abuse, or after common infections.
In the foreground, severe vertigo occurs at intervals, which is also accompanied by noises in the ear and a cotton-like feeling of pressure in the ear.
In the event of an attack, there is acute inner ear hearing loss that can last for a few hours. The cause is still unclear, but suspects a disturbance in the fluids of the equilibrium organ (endolymph / perilymph) and their salt concentrations (electrolytes).
Therapy is symptomatic with anti-nausea medication such as dimenhydrinate (Vomex ®). Betahistine (Acqamen retard ®) is given in the seizure-free interval.
Further information on this topic can be found at: Meniere's disease - Electrical accident
Electric current can cause severe damage to the inner ear when it is conducted through the body. Similar consequences also occur after a lightning strike. In these cases, other injuries, burns, and nerve failures also occur, which require interdisciplinary treatment.
