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When Is Sudden Hearing Loss an Emergency? An ENT in Gangnam, Seoul Explains

Answered by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

Treat it as urgent, not as a blocked ear

Sudden sensorineural hearing loss(SSNHL) is a rapid loss of hearing, usually in one ear, that develops over minutes to 72 hours. It is caused by a problem in the inner ear or the hearing nerve, not by wax or fluid. Many people wake up with it and assume they have water or wax in the ear, which can delay treatment by days. Clinical guidelines emphasize prompt evaluation because treatment is most effective when started early.

Typical symptoms

• Muffled or reduced hearing in one ear, often noticed on waking or during a phone call
• A blocked or full feeling in the ear
• Tinnitus(ringing, buzzing, or hissing)
• Dizziness or vertigo in some people
• Sounds that seem distorted or uncomfortably loud

Go to an emergency department immediately if

• Hearing loss comes with facial weakness, slurred speech, arm or leg weakness, or severe imbalance
• You have a severe headache, confusion, or double vision
• It follows a head injury

These can indicate a stroke or other neurological problem.

Why early treatment matters

The cause is often unknown; theories include viral inflammation, reduced blood flow to the inner ear, or immune reactions. The standard treatment is corticosteroids, given by mouth, by intratympanic injection directly through the eardrum, or both. Guidelines suggest starting treatment within two weeks of onset, and the sooner the better. Some people recover partially or fully even without treatment, but delays can reduce the chance of meaningful recovery.

How it is diagnosed

The key question is whether the loss is conductive (wax, fluid, eardrum) or sensorineural (inner ear or nerve). An ear examination and a formal hearing test answer this. Tympanometry checks the middle ear. An MRI is often recommended later to rule out rare causes such as a benign tumor on the hearing nerve (vestibular schwannoma).

What we do at Gangnam Yonsei ENT

Sudden hearing loss is part of our ear clinic care. Dr. Kim Yoo Suk, a board-certified otolaryngologist and former university professor at Yonsei and Ajou who treats all ear, nose, and throat conditions, examines the ear with a microscope or endoscope to exclude wax or fluid and arranges audiometry the same day when possible. When SSNHL is confirmed, steroid treatment, including intratympanic injection when appropriate, is discussed and started without delay. Follow-up hearing tests track recovery, and further imaging or referral is arranged when needed.

What not to do

• Do not wait several days hoping it clears
• Do not use cotton swabs or ear candles
• Avoid loud noise while the ear recovers

Message us on WhatsApp at +82-10-5344-4464 during opening hours or walk in; consultations are in English. See location and hours. Related: whether tinnitus goes away and what to expect at a hearing test.

Related questions

Can sudden hearing loss recover on its own?

Some people recover partially or completely without treatment, but it is not possible to predict who will. Because steroids are thought to work best when started early, guidelines recommend prompt evaluation and treatment rather than waiting.

Is an intratympanic steroid injection painful?

The eardrum is numbed before the injection, so most people feel only brief pressure or a short sting. You lie still for a short time afterward so the medication can soak into the inner ear. Temporary dizziness can occur.

Does stress cause sudden hearing loss?

Stress is often mentioned by patients, but the exact cause of sudden hearing loss is usually unknown. Viral, circulatory, and immune factors are suspected. Regardless of possible triggers, rapid evaluation and treatment are what matter most.

This answer is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Please see a doctor for an examination. In an emergency in Korea, call 119.