Diagnosis of SSHL, and the HUM test
Just before New Years I suffered hearing loss in one ear. Waited 9 days
before seeing an ENT (hoping it was wax) and was put on Predisone. Took that
treatment (60mg) for another 9 days and stopped abruptly when I didn't like
the side effects and higher blood pressure readings.
Had some improvement in hearing for a few days after that, then a relapse with
typical feelings of ear fullness, reduced hearing , and tinnitus.
No other treatment so far.
In my case I have only the the hearing loss at low and high frequencies ,
with no vertigo or other symptoms besides that nasty case of loud, single tone,
tinnitus, which thankfully has subsided for the last few days.
The diagnosis I have received so far is sudden sensorineural hearing loss, a
catch all for many possible causes.
Is anyone here familiar with the HUM TEST? "Harris adds that if a person had
normal hearing before getting a head cold, there is a simple test that will
tell if a blocked ear is from congestion or nerve damage: Hum out loud. If you
hear your voice louder in the blocked ear, the problem is congestion and is
probably temporary. But, if you hear your voice louder in the good ear, this
indicates possible nerve damage in the blocked ear. "
I'm my case I hear my voice clearly centered when I talk, and when I block one
ear at a time , I hear humming louder in the blocked ear. This is exactly
opposite what sshl in the bad ear should produce . I mentioned this to an ENT
and he wasn't too impressed , but I'm suspicious this problem I have may be
incorrectly diagnosed. Definitely a problem , but might be middle ear related
and not cochlear.
For those of you with confirmed sshl , what are your results when you try that hum test yourself?
Last edited by joe58; 02-06-2012 at 03:59 PM.
9 days and stopped abruptly ain't a good idea.
if you don't trust your current ENT get a second opinion.
I had never heard of the HUM test so I googled it. It's meant as a triage tool to be used within the first 72 hours of a sudden sensori-neural HL. It does sound strikingly similar to the tuning fork tests that can be done to get a brief assessment of weather hearing loss is conductive or sensori-neural. Thing is about sudden losses they need to be seen and treated ASAP in order to potentially restore any of the lost hearing if it is, in fact, a Sudden-SNHL. It's unfortunate that you weren't able to complete the steroid treatment as that's usually the best/most commonly used method. There are also some trans-tympanic injection methods that can be used. Also, a diagnosis of Sudden- SNHL is just that (not a catch-all). If you have SNHL and it happened suddenly then that is the appropriate diagnosis. They will probably never know the cause, but in general we never truly know 100% what causes HL.
The response you are describing when you block your ear when humming is called the occlusion effect. I have normal hearing in both ears and when I do the same thing, I also get an increase in volume. What happens is the sound you hear when you speak/hum is heard through the vibration of bones in your head. If you plug your ear, when these vibrations reach the ear canal, they become stuck between the eardrum and the blockage in the ear canal. The blockage bounces these vibrations, which otherwise would exit through the ear canal, back at the eardrum. This can cause an almost 20 decibel increase in sound pressure in the ear. You basically give yourself a conductive hearing loss by plugging your ear. If you're trying to do these kinds of tests then pay more attention to where the sound localizes instead of where it's louder.
If you had a hearing test and they found SNHL then I'm not sure why you are continuing to do the self-tests at all...unless you question the results of the hearing evaluation. It's possible there has been improvement since the last test, perhaps an additional hearing test is in order? Working with an ENT, the answer lies in the audiogram...tuning fork tests help indicate where the problem could lie but the final answer lies in the audiogram.
I do regret not continuing with the Predisone, but I was on the highest dose for 9 days (60mg/day) so it's not as if I didn't get some benefit from it. I'm not sure if the taper over the next week would have made a huge difference. I told the ENT over the phone that I was seeing a spike in blood pressure, and his suggestion was to stop taking the Pred. Guess we both panicked at that.
If there was profound nerve damage I would expect the hum test to "fail" in the bad ear. As that ear would not be responding to sound externally or internally . In my case I still have considerable hearing , albeit at a reduced db level in the very low freq and very high, so I may be hearing the midrange, which is reasonably intact if a bit distorted ,when I do the hum test. I can hear the dialtone at the same db level, but with a different pitch. Just an educated guess on that.
Just for background, I have always had excellent and overly sensitive hearing. I'm 58, and have gone out of my way all my life to protect my ears from loud noise, and even slept with earplugs for years to block out noise.
As you can imagine this has been quite traumatic, and I'm grateful that I still have 100% hearing in one ear, and a marginally usable other. Just hoping that whatever caused this isn't lurking for an encore.
Due for another hearing test in a week, but not sure what that will do for me. It's quite shocking how little medical science can do for this affliction at this point in time.
his suggestion was to stop taking the Pred
there always seems to be a rest of the story..
another hearing test in a week, but not sure what that will do for me
if you think it's a waste of time/$$$ don't go.
Week 6 since the shl, and still seem to be recovering slowly , with bouts of tinnitus occurring every few days , not daily. Last night wasn't fun after a few days of relative peace.
Using the dialtone of the phone as a reliable reference, I check every day to see how 'distorted' the sound is vs the good ear.
This afternoon, it was it's usual HIGHER pitched tinny sound, but with equal volume to the good ear. Could make out speech clearly as well, a substantial improvement over previous weeks.
Tonight, the dial tone is almost 100% normal , as is speech. I am taking nothing since the prednisone weeks ago (some extra B12 & Zinc + Multi) . Also, got my blood pressure under control with meds (from 140 to the low 120's) and watching salt intake.
Does anyone have any insight as to what might be going on here? If there was permanent damage to the cochlea , this improvement would not be possible.
I was about to say Im pretty sure my very low and very high freq hearing was probably not back , but I checked this on the computer, and I can once again, for the first time in 6 weeks, hear 100hz and even below and 10,000k on the high, with only minor db reduction and distortion.
Hoping this is a permanent recovery, and thought it might be useful to post this as 99% of the posts I've read on sshl seem to have poor outcomes.
Last edited by joe58; 02-09-2012 at 09:44 PM.
Unfortunately when it comes to sudden SNHL there's really no way to know for sure what caused it and there is a WIDE range of amounts of recovery from complete to none at all, even with an aggressive treatment. I would think the 9 days probably did something although not sure what.
The repeated hearing tests are important to document the changes. Probably will never know what caused it to happen. We see a few cases of sudden SNHL each month and many have little-no recovery. I'd say you lucked out on this one...Congratz!!!
A proper audiogram will determine with certainty with you have a inner ear or middle ear hearing loss.
My understanding is about a third of people recover all of their hearing, usually within a few days, another third get some back with treatment, usually within a month, sometimes longer and another third get no improvement no matter what they do.
I suffered a unilateral snhl about 6 weeks ago also with tinnitus. I didn't get it properly diagnosed until 2 weeks in and did three weeks of oral prednisone followed by two steroid injections with zero improvement. I finished the treatments about two weeks ago and there has been no change since. My loss is severe in my right ear, about 55 -60 db in mids and high frequencies, less at the lower frequencies and the sound is quite distorted. If I plug in an earphone to that ear only and play voices they sound a bit they're helium.
Anyone know if a hearing aid can clean that sound up enough to make it worthwhile? The way it sounds, I wouldn't want it any louder unless it sounded more normal.
An update and a question.
Hearing has been quite variable, but overall mild improvement and much less tinnitus. Thank g*d.
Scheduled finally for 2 mri's (had a cat scan already) in a few weeks.
This is whats really strange. One way I test my hearing is by the sound of the phone dialtone. Most times, its much higher pitched and tinny in the bad ear.
This am , shortly after waking, it was nearly a perfect match for the good ear. A half hour later , after a bit of coffee and bagel, it was back to a much higher pitch.
wtf? Clearly, there is something quite odd going on. Has anyone heard of this, my research has not revealed a syndrome that fits my case.
lol , hearing that dialtone normally again. coffee?