What is SSNHL?

• SSNHL is an ENT medical emergency in which sudden loss of hearing occurs suddenly or over a while.
• In most cases, SSNHL is unilateral.
• The typical age group affected is 40 to 50 years.

What causes SSNHL?

• Studies have shown that in 90% cases, SSNHL is idiopathic( occurs due to unknown cause)

What are the Symptoms of SSNHL?

• High pitch sounds are muffled.
• Dizziness
• Ringing in ears. (Tinnitus)

How is SSNHL Diagnosed?

• Medical history and physical exam.
• While performing the physical examination, your doctor may ask you to cover one ear at a time and listen with the other ear while listening to sounds at different volumes.
• Your doctor may also perform some tests using a tuning fork; an instrument used to measure the vibrations in your ear.
• Using these test results, the doctor will check for damage to the middle ear and eardrum parts.

Audiometry tests can check your hearing more precisely. During audiometry, an audiologist will test your hearing ability using earphones. The doctor may send a series of different sounds at different levels that may be sent to each ear individually. An audiometry test can help the doctor determine the level at which your hearing begins to fade.

An MRI scan will be suggested by your doctor to look for any abnormalities in your ear, such as tumors or cysts. MRI makes detailed pictures of your brain and inner ear, which will help your doctor find the underlying cause of SSHL.

How is SSNHL Treated?

• Early treatment increases your chances for a rapid and full recovery.
• In some cases, the doctor can surgically insert a cochlear implant into your ear. The implant doesn't completely restore hearing, but it amplifies the sounds to a more normal level.

Intratympanic Steroid Injections for SSNHL:

• Steroids are the most common treatment of SSNHL.
• Steroids can reduce inflammation and swelling. The doctor may also prescribe antibiotics if an infection is the cause of your SSHL.

Procedure:

• Intratympanic steroid injections are relatively simple to perform, and a large number of ENT surgeons perform them.
• The patient is placed supine ( arms facing upwards)in a chair.
• The topical anesthetic solution (phenol) is applied to the anteriosuperior quadrant of the tympanic membrane.
• An aqueous steroid (Dexamethasone or Methylprednisolone) is then injected through the anesthetized region until the middle ear is full.
• The patient remains supine with the injected ear pointed up for 20–30 minutes to facilitate steroid passage across the round window membrane.
• Studies have shown that Intratympanic steroids are safe and minimize the side effects associated with systemic steroids.

When is an Intratympanic Injection used?

The most common reasons for Intratympanic steroid injection are:
Menière's disease:
Menière's disease is a condition of the inner ear in which episodes of severe vertigo(loss of balance) can last up to several hours at a time. In Meniere's' disease, vertigo is associated with tinnitus and hearing loss in the affected ear and nausea and vomiting on occasions.

Sudden vestibular failure:
In some instances, the patient may suffer from a sudden loss of hearing associated with vertigo, which can last for many days. The cause of this is unknown. Premature vestibular failure causes inflammation and damage to the delicate internal ear structures. As a result, steroid injections became popular due to steroid medications' ability to reduce inflammation and congestion.

What to Expect after Intratympanic Steroid Injection for SSNHL?

You will be sent back to the recovery area, where the doctor will take necessary observations like checking your Blood Pressure and Pulse rate.

• It is ubiquitous to experience ear fullness, tinnitus, or even dizziness after the procedure.
• You will be allowed to eat food and drink water.
• It not too painful.