The morning Dad's ear went quiet: sudden hearing loss and why we didn't wait
It was a Sunday in February. Dad called me at eight in the morning, which he never does, and said his left ear "felt full of water" and the phone sounded tinny. He thought he'd gotten water in it in the shower. He planned to put some drops in and wait a week.
I almost agreed. I'm glad I didn't, and I'm writing this so that the next person who gets that phone call knows what we didn't.
What sudden hearing loss is
Sudden sensorineural hearing loss, sometimes called sudden deafness, is a fast drop in hearing, usually in one ear, over a few hours to a few days. It's often noticed on waking or when someone holds the phone to the bad ear. People describe it as fullness, pressure or a blocked ear, and it often comes with new ringing and sometimes dizziness.
The reason it matters: it can look exactly like a blocked ear, but it's a problem in the inner ear or the nerve, and the treatment works best when it starts early. The NIDCD's page on sudden deafness calls it a medical emergency and says to see a doctor immediately.
How we decided not to wait
I'd read about a simple check months earlier, and I asked Dad to try it over the phone. Hum with your mouth closed. If the hum sounds louder in the blocked ear, it's more likely something in the ear canal or middle ear, like wax or fluid. If it sounds louder in the good ear, the inner ear may be involved.
Dad said the hum was louder in his right ear, the good one. That's when I got in the car.
It isn't a diagnosis, and a doctor uses a tuning fork to do a more careful version. But it was enough to move us from "wait a week" to "go today." A good rundown of the common causes of a muffled ear, from wax to fluid to the serious kind, explains the hum test and when each cause needs a doctor.
Our first 48 hours
| When | What happened | What I'd tell you |
|---|---|---|
| Sunday, 8 am | Dad calls: left ear full, phone sounds tinny, a new hiss | Ask whether it came on suddenly and whether there's dizziness |
| Sunday, 9 am | Hum test: louder in the good ear | Don't put drops or oil in an ear nobody has looked at |
| Sunday, 11 am | Urgent care: no wax, no fluid, eardrum normal. Referred to ENT | Say the words "sudden hearing loss" at the front desk |
| Monday, 2 pm | ENT and same-day hearing test: sudden sensorineural loss, left ear | Bring a list of his medicines and when it started, to the hour |
| Monday, 4 pm | Started a course of oral steroids | Ask about the plan if the pills don't suit him |
| Two weeks later | Follow-up hearing test, partial improvement | Keep the follow-ups; recovery is checked with tests, not feelings |
Why the clock matters
The American Academy of Otolaryngology's 2019 guideline on sudden hearing loss asks doctors to separate sudden sensorineural loss from simple blockages quickly, get a hearing test, and offer treatment within two weeks of when it started. Earlier is generally better. About half of people get some or all of their hearing back on their own, but nobody can tell in advance who'll be in that half.
The usual treatment is a corticosteroid, either as pills or as injections through the eardrum into the middle ear. Dad's ENT gave us both options and explained the trial that compared them.
Pills versus injections
A randomized trial published in JAMA in 2011 compared the two head to head in 250 people with sudden hearing loss of at least 50 dB, all treated within 14 days of onset. One group took 60 mg of oral prednisone a day for two weeks plus a taper. The other got four steroid injections into the middle ear over two weeks.
Improvement in pure-tone average, in decibels, for people with sudden hearing loss treated within 14 days.
| Treatment | Hearing recovered |
|---|---|
| Oral prednisone (121 people) | 30.7 dB |
| Steroid injections into the ear (129 people) | 28.7 dB |
Source: Rauch and colleagues, JAMA, 2011.
The two came out essentially the same. The researchers' conclusion was that injections were not worse than pills, which matters for people who can't take high-dose oral steroids, like some people with diabetes. Dad's blood sugar was fine, so he went with the pills.
What struck me about those numbers: an average of around 30 dB recovered is a lot. It's the difference between normal conversation sounding like a whisper and sounding close to normal. That's what you give up the chance of if you wait a month to see whether the drops worked.
How it turned out
Dad got back a good part of his hearing in the left ear, but not all of it. His follow-up tests showed a mild loss that stayed, on top of the age-related loss he already had in both ears. The new hiss in that ear faded over a few months and now he only notices it at night.
He also got a proper hearing test out of the whole thing, which he'd been putting off for years. That turned out to be the start of the next chapter, the hearing aids.
One more good thing came out of it. For the first time, Dad had a full audiogram on file for both ears, dated and signed. When his right ear changes later, and at 79 it probably will, his ENT will have something solid to compare it to. I keep a photo of it on my phone with his medicine list.
What I'd want any family to know
- Sudden hearing loss in one ear is an emergency, even when it's painless and even when it feels like water in the ear.
- Use the words "sudden hearing loss" at urgent care or the ER.
- Don't put drops, oils or candles in the ear first.
- If there's sudden weakness, numbness, slurred speech or severe dizziness along with it, call 911. That can be a stroke.
- Supplements have no role here. Nothing on a store shelf treats sudden hearing loss.
The best plain-language piece I found afterward on sudden hearing loss and why the clock matters covers causes, recovery odds and the follow-up. I keep a copy of the link in Dad's phone notes, next to his medicine list, in case it happens to the other ear. For a sibling who wants the general background on hearing problems without the medical jargon, the MedlinePlus page on hearing disorders and deafness is a good starting point.