If one ear suddenly goes muffled, hollow, or strangely quiet—like someone pressed a foam earplug into your head—don’t wait and see. That scenario can be a hearing emergency called sudden sensorineural hearing loss (SSNHL), and the most effective treatments work best when started quickly. Here’s what happens next, why the clock matters, and the options your care team may offer.
Sudden Hearing Loss, in Plain English
SSNHL often shows up over minutes to hours (or upon waking) as a rapid drop in the inner ear’s ability to convert sound into signals the brain can use. People describe:
- A plugged, full, or echoey ear that doesn’t clear with swallowing
- Distorted sound quality (voices sound robotic or off-pitch)
- A sudden increase in tinnitus (ringing, buzzing, or roaring)
- Possible dizziness or imbalance
It’s different from a simple blockage (earwax) or a middle-ear issue (fluid from a cold), which are conductive problems. SSNHL is an inner-ear problem. The challenge: they can feel similar at first. That’s why you want an urgent ear exam and a same-day or next-day hearing test (audiogram) to sort it out.
Gentle nudge: if this sounds like you, contact an ENT clinic or urgent care and say the words, “sudden hearing loss.” That phrase helps staff prioritize your appointment. An audiologist is often part of the rapid workup.
Why the Clock Matters
The inner ear is delicate real estate. Inflammation and metabolic stress after a sudden hit (often idiopathic—no clear cause) can injure hair cells and their neural connections. Steroids reduce inflammation and may improve the odds of meaningful hearing recovery, especially when started early.
Translation: the sooner evidence-based treatment begins, the better your chances. Guidelines emphasize starting therapy within days (ideally within 48–72 hours), with meaningful benefit still possible for a couple of weeks—and “salvage” options sometimes considered beyond that window.
The Treatments You’ll Hear About
1) Oral steroids (pill form)
Often the first-line option. Prednisone or equivalent is commonly prescribed for a short course, typically about 1–2 weeks with a brief taper. Your clinician will tailor dosing to you.
What to know:
- Why: Systemic steroids calm inner-ear inflammation and swelling.
- Evidence: Long used and guideline-supported for SSNHL. Best started early.
- Side effects (short term): Jittery energy, sleep trouble, mood changes, increased appetite, elevated blood sugar, blood pressure changes, reflux. Most are temporary and monitored.
- Who needs extra caution: People with diabetes, glaucoma, stomach ulcers, uncontrolled hypertension, or significant infection risk. Always review your medical history and medications with your clinician before starting steroids.
2) Intratympanic steroid injections (shots through the eardrum)
Don’t let the phrase scare you. This is an in-clinic procedure using topical anesthesia. A tiny amount of steroid (often dexamethasone) is placed through the eardrum into the middle ear, where it diffuses into the inner ear.
Where it fits:
- Alternative to pills if you can’t take oral steroids.
- Combination therapy with oral steroids in some cases.
- Salvage therapy when recovery is incomplete after initial treatment.
What to expect:
- 1–4 injections over 1–2 weeks, usually quick visits
- Temporary taste change or brief dizziness is possible
- The tiny hole in the eardrum typically heals on its own
Evidence from clinical trials suggests similar overall outcomes to oral steroids in many scenarios, with the perk of delivering high drug levels to the inner ear while limiting whole-body exposure.
3) Hyperbaric oxygen therapy (HBOT)
HBOT involves breathing 100% oxygen in a pressurized chamber to increase oxygen delivery to inner-ear tissues. It’s considered an adjunct option—not universally available—and is often used early (within two weeks) or as salvage within about a month, typically alongside steroids.
Real talk:
- Access varies by region and insurance.
- Commitment: Multiple sessions (often daily for several days).
- Evidence: Mixed to moderate; some patients improve, especially when used early. Your ENT can advise whether it fits your case.
Treatments generally not recommended
- Antivirals, antibiotics, or vasodilators aren’t routinely helpful unless a specific infection is identified.
- Vitamins and supplements haven’t shown consistent benefit for SSNHL recovery.
- Decongestants treat nasal congestion but won’t fix inner-ear hearing loss.
What else is part of care?
- Urgent audiogram: Establishes baseline and guides treatment.
- Follow-up testing: Repeat audiograms to track recovery over weeks.
- Imaging (often MRI): Sometimes used to exclude rare causes like a vestibular schwannoma (acoustic neuroma), especially with persistent unilateral loss or asymmetry.
Your First 24–72 Hours: What to Do
- Call now: Reach out to an ENT or urgent care and use the phrase “sudden hearing loss.” Ask for a same-day or next-day audiogram if possible.
- Get examined: A clinician can rule out earwax or a middle-ear issue and confirm whether SSNHL is likely.
- Discuss steroids promptly: If SSNHL is suspected, your clinician may start treatment right away—oral steroids, injections, or both—based on your health profile.
- Flag your conditions: Share if you have diabetes, glaucoma, ulcers, mood disorders, or are on blood thinners or immunosuppressants.
- Skip DIY fixes: Don’t self-start ear drops or high-dose supplements unless instructed. Avoid loud noise and avoid stopping any prescribed medication without medical guidance.
Note: A recent cold with ear pressure can cause temporary conductive hearing loss (fluid), but it can also coincide with SSNHL. The safest move is evaluation right away rather than waiting for it to “clear.”
What Recovery Really Looks Like
Recovery is a spectrum. Some people bounce back almost completely; others improve partially; some have lasting hearing changes. Factors that influence outcomes include the degree of initial loss, configuration on the audiogram, how fast treatment started, and whether severe dizziness was present.
Typical timeline:
- Days 3–14: Early signs of change—clarity improves, tinnitus shifts, pure-tone thresholds inch better.
- Weeks 2–6: Continued recovery for many; care team may consider additional injections if improvement stalls.
- Up to 3 months: Further gains possible; beyond that, hearing tends to stabilize.
If residual hearing loss remains, that’s not the end of the road. Audiologists have powerful tools:
- Hearing aids tuned for clarity and tinnitus support
- CROS/BiCROS systems if one ear doesn’t recover well
- Remote microphones to boost speech in noise
- Tinnitus management (sound therapy, counseling, CBT-based approaches)
When loss is severe and durable, cochlear implant evaluation may be appropriate. Don’t be shy about asking your audiologist—even if you’re early in recovery—to map out “if/then” options so you feel in control.
Tinnitus and the Emotional Side
A sudden change in hearing can rattle anyone. Tinnitus may get louder, your head may feel “off,” and sleep can suffer. Two anchors help: a clear plan and a clear timeline. Ask your clinician exactly when you’ll re-test hearing, when to consider additional injections, and when to discuss rehab options.
Meanwhile, simple practices can reduce brain alarm signals:
- Use neutral sound at night (fan, gentle noise app) to soften tinnitus contrast
- Keep daily routines and movement going—your balance system likes it
- Limit doom-scrolling; set specific check-in times for updates and questions
If anxiety spikes, brief counseling or CBT-based tinnitus support can make a big difference. Your clinician can refer you.
Follow-Up and Prevention Mindset
- Scheduled audiograms: Many teams check at ~2 weeks, 4–6 weeks, and 3 months.
- MRI consideration: Especially if recovery is incomplete or there’s ongoing asymmetry.
- Heart–ear health: Keep blood pressure, blood sugar, and sleep apnea well-managed; what’s good for vessels is good for the inner ear.
- Sound hygiene: Protect against loud noise while you recover; use hearing protection at concerts, power tools, and loud venues.
Finally, if you’ve had one episode, stay attuned to your ears. If anything like it happens again, you’ll know to act immediately.
Myths vs. Facts
- Myth: “It’s probably just earwax—I’ll wait.”
Fact: It might be, but waiting can cost precious recovery time if it’s SSNHL. Get checked. - Myth: “Decongestants will fix it.”
Fact: They can help nasal symptoms but don’t treat inner-ear hearing loss. - Myth: “If steroids don’t work in 48 hours, nothing will.”
Fact: Improvement often unfolds over days to weeks, and salvage treatments may help.
The Takeaway
Sudden hearing changes deserve the same urgency you’d give to vision changes. Early evaluation and steroid-based therapy—by mouth or via quick in-office ear injections—can tilt the odds toward recovery. If you’re unsure where to start, call an ENT clinic or a local audiology practice and say, “I think I have sudden hearing loss—how soon can you see me?”
Further Reading
- 72 Hours Matters: Treating Sudden Hearing Loss Without Losing Time (Treatment) - Act Fast: The Real-World Playbook for Treating Sudden Hearing Loss (Treatment) - Sudden Hearing Loss: The 72-Hour Treatment Playbook (What to Do Now) (Treatment) - Sudden Hearing Loss Needs Speed: Treatments and the Critical Window (Treatment)Frequently Asked Questions
Is sudden hearing loss really an emergency?
Yes. Inner-ear hearing that drops over hours or overnight has the best chance of recovery when evaluated and treated quickly—ideally within the first 48–72 hours. Call an ENT clinic or urgent care and request an urgent audiogram.
What if it’s just earwax or fluid from a cold?
Those can mimic the feeling of a plugged ear, which is why an exam and hearing test matter. If it is wax or middle-ear fluid, great—it’s treatable. If it’s SSNHL, you’ll be glad you didn’t wait.
Do steroid shots in the ear hurt?
Most patients tolerate intratympanic injections well with topical numbing. You may feel a brief pressure or pinch. Visits are usually quick, and the tiny eardrum opening typically heals without issues.
Will treatment make my tinnitus go away?
If your hearing improves, tinnitus often eases. If some tinnitus remains, audiologists can help with sound therapy and counseling approaches that reduce its impact, even if the sound doesn’t fully disappear.
