Sudden Hearing Loss

Many types of hearing loss happen gradually over a period of months or years. Sometimes, hearing loss can occur suddenly without any warning. Sudden hearing loss often affects one ear and may be accompanied by tinnitus and/or vertigo. When hearing loss occurs suddenly, it is critical to receive treatment ASAP. Sudden hearing loss is considered a medical emergency due to the time sensitive nature of receiving treatment to restore hearing sensitivity.

According to the Clinical Practice Guideline for Otolaryngology Head & Neck Surgery, sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually (about 66,000 each year in the United States). Sudden sensorineural hearing losses are often idiopathic, meaning the cause is unknown. Only 10-15% of individuals who experience a sudden hearing loss have had the cause diagnosed. Some risk factors or causes have been identified as:
-Infection (bacterial or viral)
-Head trauma
-Autoimmune diseases 
-Inner ear disorders

Although the cause of a sudden sensorineural hearing loss may not be known, treatment of the loss is still possible. The Clinical Practice Guideline for Otolaryngology Head & Neck Surgery recommends the following:
-Audiometric evaluation within 14 days of symptom onset to confirm the diagnosis
-Oral and/or intratrympanic steroid therapy within 14 days of symptom onset
-MRI to rule out retrocochlear pathologies

Patients may recover some hearing within the first two weeks–the degree of recovery varies greatly patient to patient. Although there is limited evidence-based data, early intervention and treatment often results in greater recovery of hearing sensitivity. 

If you or someone you know experiences a sudden hearing loss, please call our office at 904-399-0350 as soon as possible. 

Home Sweet Home: Safety and Fall Prevention

According to the National Center on Aging, 1 in 4 people over the age of 65 fall each year.  Even more concerning, falls often result in hospitalization or nursing home stays, and are the top cause of fatal injury in aging adults. Up to 75% of falls occur in a person’s home, so it is wise to evaluate your space to make it safer. Here are some places to consider:

  1. Trip Hazards: Collision with objects in the floor, such as rugs, cords, or other clutter can cause a fall. If possible, try to move these objects away from the main walking path so you are less likely to trip. Also remember that your home may have other uneven walking surfaces, such as stairs or door thresholds, which can also pose a tripping risk. Railings can be added in these areas to provide a place to grab for support if needed.
  2. Lighting: Ensuring that all floors are properly lit, especially at night, can help prevent falls. Consider using a nightlight to provide extra illumination in the dark.
  3. Bathroom: The bathroom can be one of the riskiest places in a home. Adding safety features such as grab bars around the toilet or tub, or non-slip mats/decals in the shower, can help prevent accidents. A non-slip shower chair may be a good option for someone that feels unsteady standing while showering.

People suffering from chronic dizziness or imbalance are at a higher risk of falling. Call our office at 904-399-0350 to schedule an evaluation if you experience these symptoms.

The Relationship of COVID-19 and the Ear

There are many viruses that can impact the ear, and recent reports have shown that the SARS-CoV-2 (COVID-19) virus can be added to that list.

Respiratory issues are one of the most common symptoms of COVID-19; however, it is known that it is not the only. Some patients may notice a decline in some of their senses or even a complete loss of their sense of smell and taste. The resolution of these symptoms can occur by the time the virus alleviates or can also linger for a few weeks to months.

Hearing is another sense that is sometimes affected by the virus. Recently, researchers have found that the tissue contained in the human ear contains proteins that are susceptible to being targeted by the COVID-19 virus, which can lead to hearing loss, ringing/buzzing in the ears, and/or balance issues.

This is not to say that if you have the virus that it would definitely impact the ear. Some patients have reported an onset of hearing loss, tinnitus, and/or balance issues alongside the onset of the virus. Many times, these symptoms may resolve within 7-14 days as the virus resolves, but some patients may have lingering effects, depending on the severity of the virus (just like the loss of smell and taste).

If you have experienced an onset or increase in hearing loss, onset or increase in tinnitus, and dizziness or balance issues, it is important to see an otolaryngologist to evaluate your symptoms.   

What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) is a common inner ear problem that causes short episodes of sudden vertigo, or the sensation that the room is spinning. Some people also have symptoms of lightheadedness, nausea, or vomiting that occur as well. BPPV episodes are typically very short, lasting only seconds to a few minutes.

Symptoms of BPPV are triggered by sudden changes in movement, such as rolling over or sitting up in bed, bending the head forward to look down, or tipping the head backward to look up.

BPPV occurs due to changes within the inner ear balance organ. Deep within the inner ear, there are 3 small structures called semicircular canals. The semicircular canals help us detect motion and maintain balance. BPPV is caused by tiny calcium crystals moving out of place and becoming free floating in one of the semicircular canals. These crystals move around in the canal with changes in gravity and head position. This interferes with the signal sent from the inner ear to the brain, resulting in vertigo.

For some people, symptoms of BPPV resolve on their own. BPPV can also be treated with a procedure that guides the dislodged crystals back into place. In many cases, the symptoms resolve after these treatments. If you believe you may be suffering from BPPV, call our office at 904-399-0350 to schedule an evaluation.

Dizziness, Vertigo, and Imbalance – What’s the Difference?

Dizziness and balance problems are very common complaints reported at primary care physicians’ offices and emergency departments. According to the National Institute on Deafness and Other Communication Disorders, on average 15% of American adults (an estimated 33 million people) report dizziness or balance problems annually. There are many ways these symptoms can be described. Below are three of the most common descriptors for these problems.

Vertigo is a term used to describe a sense of spinning or motion. Some people report that it feels like the room is spinning around them, while others feel like they themselves are moving, even when they aren’t. Vertigo is a symptom, not a disease itself. Vertigo may be caused by many different factors, including inner ear problems.

Imbalance refers to a feeling of unsteadiness on your feet. Some people report they may sway or veer to one side when walking or standing. This can lead to an increased risk of falling, which can result in serious injuries.

Dizziness is a general term used to describe a range of symptoms. This may include vertigo or imbalance as described above.  It may also include symptoms such as lightheadedness or feeling faint, wooziness, motion intolerance, or other descriptions. When in doubt, dizziness is a catch-all term that many healthcare providers use before a specific disorder or impairment is diagnosed.

Although these symptoms can be very concerning, the good news is diagnosis and treatment options are available. If you are experiencing dizziness, vertigo, or imbalance, contact our office at 904-399-0350 to schedule an evaluation.

It is recommended you seek emergency medical care immediately if you experience severe dizziness or vertigo along with symptoms such as severe headache, chest pain, difficulty breathing, numbness in the arms or legs, confusion or slurred speech.

Superior Semicircular Canal Dehiscence Syndrome

What is superior semicircular canal dehiscence syndrome?
Superior semicircular canal dehiscence syndrome (or SSCDS) is a condition where the normal bony covering of the superior semicircular canal (one of the three balance canals that respond to angular acceleration) is missing.

What type of symptoms do patients with SSCDS have?
Many, but not all, patients with SSCDS have dizziness. This dizziness may be brought on by loud noises, such as the clanging of dishes together, or by pressure changes, such as sneezing, coughing, or straining. Some patients report hearing their heartbeat in the affected ear and often complain of ear fullness. Many patients describe that their voice sounds louder in one particular ear as well. Other less common symptoms include hearing one’s own eye movements and hearing one’s own footsteps on certain surfaces (watch this video: Inside Todd’s Head).

What causes SSCDS?
Currently the exact cause of SSCDS is not known. It is likely that some individuals are predisposed to the thinning of bone in certain areas of the skull base, leading to problems such as SSCDS. Additionally, head trauma may play a role in certain cases of SSCDS. Not all individuals with a dehiscence of the superior semicircular canal (as might be seen on a special CAT scan and verified by certain tests) actually have symptoms.

How is SSCDS treated?
SSCDS treatment must be individualized to each particular patient. While there is no specific medical therapy for SSCDS, various surgical management options are available.

The information and reference materials included on this website are intended solely for the general information and education purposes of the reader. They are not intended nor implied to be a substitute for professional medical advice or to diagnose health problems. The reader should always consult his or her healthcare provider to discuss the information presented here.

Vertigo in the Headlines

File:Stephen Colbert at Montclair Film 2017 (1).jpg - Wikimedia Commons

Late night talk show host Stephen Colbert announced recently that he has been diagnosed with Benign Paroxysmal Positional Vertigo (BPPV). He reported that when he would stand up from a seated position, everything began to spin and subsequently he would fall or sit down. This particular type of vertigo is characterized by the sensation of either yourself or the world around you spinning, and lasting for a few seconds to a few minutes. It is typically brought on by head movements such as rising from a seated position, moving you head in a certain direction, or rolling over in bed.

Symptoms associated with BPPV are imbalance, nausea/vomiting, and visual changes such as objects seeming to jump or moving side to side. Possible causes can include head injury, ear surgery, migraine headaches, transient ischemic attacks or stroke, a growth inside the ear, or a virus within the ear.

BPPV can usually be corrected with special positioning treatments done in the office and exercises at home. However, it is important not to assume that all vertigo is BPPV and to make sure any causes aside from the inner ear are ruled out first. Contact your primary care physician if you begin to experience dizziness. Once cleared, they will then refer you to a hearing and balance specialist to help determine the cause of vertigo and develop the next steps to help correct it.

Balance Awareness Week

Here at Jacksonville Hearing and Balance, we focus on all aspects of the ears and their functions, everything from ear wax removal to complex balance disorders. Your ears not only control your ability to hear, but also play an integral role in your balance. This system is called your vestibular system.

Balance awareness week, September 13 – 19, was established by the Vestibular Disorders Association (VeDA) in an effort to raise awareness of these types of disorders. There is a broad spectrum of vestibular disorders that can are short in duration but some that can also affect patients throughout their life.  Our goal is to help diagnose and lead you to the correct path of treatment.

According to VeDA, there are more than 69 million Americans who are affected by balance disorders. Patients typically describe themselves as “dizzy” or “off balance”. For some patients, they report difficulty while in the dark.  Although these disorders can present in different ways, all can have a significant impact on a person’s quality of life. 

Here are a few links talking about Balance Awareness Week and Vestibular Disorders:

If you do have difficulty with balance, here are some tips to help in your daily life:

  1. Speak with your doctor about your symptoms
    • Your primary care doctor can help point you in the right direction
  2. Try to keep track of your symptoms. 
    • What causes it?  What makes it worse? Better?
  3. Remove trip hazards from your home
    • Clear main pathways in your home, i.e. from bed to bathroom,
    • Remove or tape down any area rugs that could have the corners pull up
  4. Make sure there is adequate lighting
    • Use of nightlight in the home in high traffic areas
    • Use of outside lights around steps or uneven surfaces
  5. Footwear
    • Footwear should be of adequate fit, not slide off when walking, and be comfortable