Some hearing recovery but after 10-11 months, I'm baffled

I understand how it feels. Don’t worry. I’ve been in the hell. I don’t know about your particular situation and how much you lost but since you mention hearing aids certainly you had it much worse. Is hard to feel totally empathy from the others in such problems. When I was a kid I had a friend with total hearing loss, she was never able to talk, nor to hear. Somehow I was thinking I feel for her but since I didn’t had such a big sudden drop in hearing I didn’t realize how hard it is without senses. On the other hand she had it since birth so I guess is less dramatic in her vision. Is one thing to have good hearing for 42 years and then loose it. But I do remember she had blasting tinnitus from time to time because she was covering her ears and I asking her what’s wrong and she wasn’t able to explain me just showed me something suggesting chaos. Now I suppose was some sort of tinnitus.

I’ve seen a case of bilateral SSNHL after covid that was severe and improved to mild after a year and a half, and the ENT said she’s seen a few more cases like that associated with covid. Odd.

Anecdotally, I tend to see recovery in SSNHL more often when it hits low frequencies instead of highs.

Lows like, eh. . . I don’t have enough data, but maybe 1000hz and under.

No, ultra highs aren’t tested enough. It’s an interesting question. My gut says they wouldn’t come back, assuming you had a pre-test (over 30 there’s a lot of loss there already). BUT they’re not tested consistently enough for me to say and I probably test them more than average. It would be hard to shove into a sudden loss appointment even for my own interest, because usually we’re jamming those patients in to an already full schedule to try to get them in and to the ENT ASAP. I’ve never had someone come in losing *just* ultra highs either–my most common reason to test up there, apart from CAPD, is if someone comes in with complaints and other thresholds are normal, so I wouldn’t expect I’d missed that. A mild high frequency asymmetry is generally less salient to people than a mild low frequency asymmetry, sudden high frequency losses who come in are often big.

I understand that’s the typical experience (and you also have to go by what has been experienced, and what can you do other than categorise and generalise to have an idea what to do) but it is also assumptions like these that make it very difficult to obtain recognition of new issues, or less-seen issues.

As an example, I am well over 30, but test at 0dB for 20kHz. I suspect a lot of my losses (relative to pre-onset) are most heavily weighted in 12-18kHz (but it has impacted everything), and my own subjective experience tells me I can no longer hear a lot of things I used to hear with ease. Based on objective tests, however, the assumption that there will be a lot of loss > 8kHz above 30 means clinicians simply dismiss the concern even when detected. (Also lack of treatment, reference data etc.)

Other assumptions/simplifications include losses in EHF don’t matter (since they don’t make up a large component of the spectrograph for many typical scenarios), but I think someone who is accustomed to having the EHF part of the spectrum would disagree - sure, the overall basic sound is “similar”, but you lose a lot of clarity/detail they are accustomed to, or basically the overall sound sounds different (resulting in processing issues). It would be like watching a video at low res and saying you can make out the basic shapes, so it’s the same, and the details don’t matter…(Someone who has never seen nor experienced high-res would say it doesn’t matter, but someone with good vision and accustomed to high-res would vehemently disagree.)

It would be interesting to have more documented cases of hearing recovery post-COVID(related) issues though, and what, if any, treatments were done. Hopefully there will be more cases and we can find a way to recover, and samyaza’s case shows that non-negligible recovery is still possible beyond the typical expected window.

@samyaza said:

All I did is taking Betahistine and Vinpocetine.

Would you mind specifying the dosage, frequency and over what time period? (was it over the entire 10-11 months?)

@samyaza said:

I had also a 3 tesla MRI came back clear!

Good to hear - can I ask what the MRI was for? (Brain? Meniere’s?) Was the previous one done, and was the previous one not clear? If not, what was the finding(s) that have since resolved?

@samyaza said:

Also, i started to hear my voice again central (almost). Back then I was hearing my voice in the right side of my head like a laser took of half of my head.

Not enough data yet, but it’s interesting that again your audio was more weighted to the right. Do you have any suggestion of if COVID (vaccine or infection) was involved in some way prior to you having hearing issues?

@samyaza said:

I would love to hear some other opinions.

The intermittent nature seems to be more common now. I also have the other symptoms you are experiencing. Not much to add here, though response to medications probably is consistent with blood flow issues, which could be due to clotting/neurological/immunological issues, amongst others.

Congrats and hope it continues to get better, and hopefully we can also improve significantly.

@ironfist said:

it is also assumptions like these

Sorry I am unclear. Assumptions like what? You mean an assumption that loss in the extended high frequencies is common over the age of 30?

This is the average hearing loss in groups of male participants over various age groups. These participants specifically were selected because they reported “no hearing difficulties”:

It is of course an average–I’m in my 40s and have hearing in the normal range from 8-20 kHz. I agree that we get a lot of information up there at the high end to support localization, speech in noise processing, and the auditory “feel” of a space.

Maybe the more interesting question is why so many people with hearing loss in that region don’t report difficulty and why some others do. But that question extends even down into the normal range, as it’s very common for people to come in claiming no difficulty and while I sit there wondering how they have even been getting by. I had a woman come in with nearly a flat 45 dB audiogram the other day and she was shocked, shocked when I told her that she had hearing loss. That’s wild to me.

@Neville said:

Assumptions like what? You mean an assumption that loss in the extended high frequencies is common over the age of 30?

Precisely, though I guess that was badly worded on my part, since that statement is not an assumption but a statistical fact. More that the assumption that as it is common, then if you have losses in the EHF within reference range, despite clear hearing complaints, that it is nothing and having concerns dismissed. (So yes, it is common, but that doesn’t mean I haven’t had losses relative to where I was particularly given my very consistent complaints.) And the assumption or “assurance” that even if there are losses in EHF range, then it doesn’t affect function much.

To be clear, using your graph as reference, I am still testing well above average in the EHF for my age bracket (even during when I kept complaining about issues). Pre-onset, those supposed “teenager only” ringtones were annoyingly loud even though I was meant to stop hearing them ages ago. Unfortunately, in the latest PTA, some particular frequencies (including not in EHF) are now slightly below the average in your graph, but the hearing issues predate the latest PTA. Only now, with the latest PTA against the previous ones, do they start to believe I’m not just crying wolf and wasting their time while spending my money…I imagine if I didn’t have the previous PTA, they would still say everything is normal and my “perceived losses” are psychogenic…

@Neville said:

I agree that we get a lot of information up there at the high end to support localization, speech in noise processing, and the auditory “feel” of a space.

Unclear what you mean by “feel” of a space, but certainly my echolocation and speed in noise processing was dramatically affected, and despite some partial recovery, it is still far less precise and accurate compared to the past. I scored outside -2SD for speed in noise at a particular time point (not necessarily at worst - just when it was tested), whereas prior to issues I didn’t have any issues, and from past general experience my hearing would likely be more than +2SD across most measures, if not +3SD. I simply can’t hear as well as before, can’t as easily distinguish between similar sounds (e.g. violin versus viola, whereas before I could, without question, tell you not only if it was a violin/viola, but which violin out of the group and where it was, easily and consistently.) It’s also harder to follow shows (by sound only) as it’s harder to tell who is speaking, if they are similar, etc. whereas all of that was effortless before. There was numerous other examples - too many to list. And it’s a relatively sharp decline (1 year), not over decades, and I definitely fall into group of people who have symptoms that are classed as long COVID. Hearing issues is just one of many, many symptoms.

It is frustrating when your difficulties are mostly ignored because objective tests either don’t test what it is that is causing your issue, and/or you are testing still above their reference so your concerns are dismissed…And if they can’t see it on the test they ran, there is then often reluctance to look further and occasionally the insinuation you’re making it up…

Use of a hearing aid has helped to some extent, but no where near to where the hearing was originally. The “character” of the sound (which I assume might be represented by the frequency distribution) is closer to original with hearing aids fitted, but certainly still very different, since the hearing aid doesn’t boost frequencies above 12kHz as far as I can tell.

@Neville said:

I had a woman come in with nearly a flat 45 dB audiogram the other day and she was shocked, shocked when I told her that she had hearing loss. That’s wild to me.

I’m not too surprised, I think plenty of people don’t know because they don’t have a reference. If you can’t hear well all your life, then you’d think that was normal. It works the other way too - I was absolutely shocked the first time I realised people actually weren’t joking when they said they couldn’t hear the (to me) annoying loud squeal from the switched mode power supply. [I can’t hear it now either after my hearing issues started.] Or that they didn’t have perfect pitch.

And the typical hearing loss is gradual, and people often get used to it over time as the changes are small and incremental. I know people who have 40dB+ losses (minimum, maybe even up to 90 in the higher frequencies) and they don’t believe they have hearing issues…and don’t believe me when I tell them they clearly do. To be fair to them, I’ve basically been saying pretty much everyone around me have hearing issues my entire life (since I’m comparing against myself), so it makes sense they ignore what I say on this point. But they still dismiss it even with a PTA saying that they do…

I only noticed my hearing issues because I still remember what it is meant to be like, and noticed things like mishearing people more frequently (which has basically not happened before), things sounding softer and more unclear etc. but no one else told me I have hearing issues. But once I paid more attention to the subtle things, I noticed that things were definitely not right and it was affecting me much more than I had initially acknowledged, and had been compensating in other ways.

@ironfist said:

if you have losses in the EHF within reference range, despite clear hearing complaints, that it is nothing and having concerns dismissed.

Yes, certainly. I think ENTs are even worse about it. I sent a child to an ENT with a huge EHF (sorry, extended high frequency) asymmetry and the ENT wrote back and said “this child’s hearing is normal” with a 25 dB screen out to 8 kHz that they had done in their office. I sent the extended test again and was like, “So what do I do about this if it progresses” and the ENT was like, “certainly if hearing loss appears send them back” and then I just slammed my head against the wall for a while and made classroom recommendations.

@ironfist said:

Unclear what you mean by “feel” of a space

Like, the way you can close your eyes and know how big a room is and get a sense for whether it is painted or wallpapered by the way it sounds.

@ironfist said:

It works the other way too - I was absolutely shocked the first time I realised people actually weren’t joking when they said they couldn’t hear the (to me) annoying loud squeal from the switched mode power supply. [I can’t hear it now either after my hearing issues started.] Or that they didn’t have perfect pitch.

Yes. Goes for all perception, really. I am probably much too old to still be surprised by individual differences, but I am. I have come to believe that for a lot of people, reading is effortful enough that when they see a sign they don’t actually know what is written on it unless they actively try–the words don’t just automatically go into their head regardless of whether they want to read it or not. That’s been a surprise. Or as another example, the internet has recently been all abuzz about aphantasia and anauralia and while I have some minor suspicions that it might all just be semantic nonsense, I would probably categorize myself as aphantasic and find it hard to belive that people really do “see” inside their head. I’m probably towards the anauralia side of the continuum, too.

And yet and yet, back to hearing, there are a lot of people who still report listening difficulties and still have normal EHF thresholds. Did you say somewhere that you have a pre-test? Can you absolutely point to a change in EHF as opposed to a change in auditory processing with the EHF loss just also being there?

For the OP? No, it would be nice if BC values were visible in avatars. I have yet to ever see a perilymphatic fistula! On my bingo card next to “bug in ear”.

I’m a Pharmacist and NOT a Physician. With that in mind, SUDDEN hearing loss is very suspicious. Sorry to ask, but have you had the hearing loss properly diagnosed? What is causing your TMD (in the U.S. TMJ) and the other trigeminal (5th cranial nerve) nerve pains? Have you tried/are you able to consult a different ENT? You might need to be evaluated by a neurologist!

I know that there are a handful of drugs that can cause sudden (and sometimes permanent) hearing loss. They do so by direct toxicity to the Auditory nerves (8th cranial nerve) or the hearing apparatus in the ear. Over the past year or so, were you treated with any such drugs? Two common ones are: ciprofloxacin, gentamycin, and at least one of the newer biologic anticancer drugs.

I write all of this because MAYBE, just maybe, if the cause can be identified, your hearing loss might be reversed and hearing aids not necessary.

Ototoxic Medications (Medication Effects)9 .

BC values? Sorry my English is not that good. Sorry for the delay. Can you ask me again?

BC is Bone Conduction.