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Jennifer
VIP
from Singapore asked a question

Is it possible to recover from hearing loss that happened many years ago?

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Ear, Nose & Throat

Hi, my mum suffered sudden hearing loss in her left ear almost 8 years ago. May I know whether there is any chance of recovery at all (at least a little)? She feels uncomfortable wearing a hearing aid as she is not used to it. She also complains of a ringing sound that's very disturbing at certain times of the day (not every day). This results in her feeling very paranoid and frustrated easily. My mom is still young, and I don't want this issue to affect her for the rest of her life. Hence, it would be great if you could suggest some options to help her cope with her hearing loss and ringing in the ear. 

DOCTOR’S ANSWER (3)

Dear Jennifer,

It is understandably very tiring for your mom, not to hear well and also to be stressed by tinnitus. Hearing loss and tinnitus makes it hard for someone to participate in social situations and conversations, and is very tiring and reduces one's mental cognition, memory and safety even.

Your mom may misunderstand what is said and feel insecure or embarrassed by mistaking things said, and thus present as paranoid, grouchy or slow in mentation.

If it was a sudden hearing loss that has been reviewed by multiple ENTs and no cause has been found by all of them and tumor excluded, the most likely cause would be viral infection, poor blood supply to the inner ear or an autoimmune issue previously.

With a hearing loss from 8 years ago, there may not be improvement now, unless it is due to an ongoing middle ear infection or growth which can be treated.

The ringing sound in her ear, also known as tinnitus, is due to her hearing loss. It is aggravated in times of stress, by caffeine or salt intake possibly, and magnified when the environment is quiet. That is why hearing aids are important for rehabilitation - as the hearing is improved and there is sound stimulation, the tinnitus can improve. 

For the hearing aid to be of help however, we will need to ensure that it is tailored specifically for her type of hearing loss, as there is a very wide range of hearing aids. We need to also do very careful tuning of the hearing aids and let her try a few different brands and models to see what works best for her. Many have personal preferences.

As with any hearing aid, we will need your mom to persist with the use as the maximum benefit may only come after a month or more, especially as this is a long-standing hearing loss. My audiologists will have to work closely with your mom and your family to support her.

Nowadays, we also offer hearing aids with specific tinnitus rehabilitation features built into the hearing aid. We will also advise on tinnitus rehabilitation therapy to reduce the tinnitus. Often, we may add a simple supplement tablet to manage the tinnitus, and add tinnitus counselling for the best results. 

Kind regards, 

Dr Lynne Lim

Consult Doctor
0 386 views 0 Doctors agree 5 Aug 2018

Dear Jennifer,

Thank you for your question. If you have been told that your mother suffered from "Sudden Sensorineural Hearing Loss", it refers to a sudden onset of hearing loss that is due to damage to the hearing organ (cochlea) or hearing nerve (cochlear nerve).

This is a condition in which most of the time, the cause is unknown. However, in some cases, this may be due to thyroid hormone imbalance, inflammation or infection of the inner ear or a growth (tumour) on the hearing nerve close to the brain. It is likely that your mother would have undergone some blood tests and even an MRI to exclude these conditions.

Sudden sensorineural hearing loss may be reversible - usually within the first 1 month of the onset of the symptom. The best time to seek treatment is within 3 days of the onset of the hearing loss. The treatment usually includes oral steroids or steroids injected into the middle ear.

If your mother's hearing loss has been eight years, it is highly unlikely that it is reversible (unless it is a conductive hearing loss). Depending on the degree of hearing loss, hearing aids and implantable hearing aids (e.g. cochlear implant) are the treatment options.  

Your mother's ringing sound in the ear (tinnitus) is likely related to the hearing loss. Some medications (e.g. Ginkgo biloba) and tinnitus counselling may help her cope with her tinnitus better.

If these measures fail, she may consider getting a tinnitus masker (a device that emit sounds/music to "mask" the sound of the tinnitus) or undergo tinnitus retraining therapy (usually with an Audiologist). The use of a hearing aid may also help reduce tinnitus.

Hearing aids are electronic devices that continue to improve at a fast pace. If your mother's hearing aid is already 8 years old, she may consider revisiting an Audiologist or a hearing aid centre to look at the reason/s that she is not wearing her hearing aid. The newer hearing aids may also have features that are more acceptable or comfortable for your mother.

Hope this helps and all the best!

Consult Doctor
0 518 views 0 Doctors agree 2 May 2018

Dear Jennifer,

I am sorry to hear that your mum has been so disturbed by the hearing loss and ringing noise in her ear for the past 8 years!

Sudden hearing loss is regarded as an "ENT emergency" i.e. if you lose your hearing suddenly, you should seek medical help as soon as you can so that appropriate medications may be started as early as possible to maximise the chances of hearing recovery.

Frankly speaking, the best chances for recovery of her hearing would have been within the first 72 hours, with many patients noticing that the peak time of recovery is within the first 2 weeks after having lost their hearing suddenly. Many ENT doctors will treat with medications up to the 6 week window: After this window, the chances of recovery begin to fall drastically. At 8 years after the sudden hearing loss happened, I'm afraid the chances of hearing recovery are very low.

I do hope that your mum has had an MRI scan of her inner ear as inner ear nerve tumours can present in a similar manner and may be the underlying cause of her sudden hearing loss. Many patients have normal MRI scans though and current research suggests that the sudden hearing loss is linked to underlying viral inflammation or perhaps, a tiny blood clot which has entered the inner ear and blocked off its blood supply.

Treatment of the sudden hearing loss within the 6 week window usually consists of a course of high dose steroid tablets and/or steroid injections into the affected eardrum which can be done smoothly and painlessly in our clinic. There is an approximately 30-50% chance of recovery of the hearing loss. What is more difficult to predict is whether the tinnitus (ringing noise in ear) will improve afterwards.

Just like in your mum's case, if the hearing fails to improve, then a hearing aid is trialled because it can also help mask the disturbing tinnitus. From my experience with many of my patients and their families, wearing a hearing aid and learning to adapt to the new quality of sound takes time, patience and perseverance. Tinnitus counselling and emotional support of the patient by my audiologist and myself is important to ensure that she continues to wear her hearing aid daily. Some hearing aids are also designed as "masking devices" which emit a band of noise at a certain frequency level to try to counter the tinnitus.

We also prescribe special supplements to try to improve the blood supply of the inner ear but results may vary from patient to patient. Simple aids to help your mum adapt to the tinnitus, especially at night, may take the form of machines which softly play certain soothing music or sounds in the background.

I do not know how severe your mum's hearing loss was, whether it was mild, moderate or severe. We find that if the hearing loss was partial, then the chances of recovery and adaptation are much better compared to cases of complete or severe hearing loss. Some patients with extremely disturbing tinnitus and complete hearing loss opt to go for a cochlear implant (inner ear implant) as all the above options have failed to help them.

So Jennifer, we do have a few options available to help your mum but the best way forward is always to see the patient herself to explore which option may be the most suitable one for her.

Consult Doctor
0 329 views 0 Doctors agree 12 Aug 2018
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