Diagnosis of SSHL, and the HUM test

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.

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.

Thought I’d update my thread.

Got all the tests done long ago. Nothing was found , other than some spurious findings that were likely irrelevant. Shadows.

The GOOD news is , and maybe this can give some people hope, is that I did NOTHING beyond that initial prednisone treatment. Had all the symptoms of loud tinnitus and fullness (very unpleasent) in the one ear. Ans significant ‘variable’
hearing loss.

This lasted for a few months but the hearing was still quite poor in the one ear. Based on my readings, after 3 or more months , recovery was supposed to be unlikely.

But slowly and surely my hearing has gotten better in the left ear, and at this point is ALMOST back to normal.

Since my right ear has the hearing of a 20 year old (I’m 59) , I’d say the left is that of a 40 year olds.

Some low frequency loss still exists but other than that, I can’t tell there’s any problem at all in daily activity or listening to music.

So there it is, have no idea what caused this, other than possibly pushing too hard with an in ear headphone a few weeks prior. Had no illness of any kind that I am aware of.

Hi joe,

I had sudden hearing loss on first of may (2013). I start improving 3 months later, I test myself every week with some mp3 files I’ve got with all frequencies, and I’ve noticed that I’ve been improving until last week, that my test was worst than the week before. I’ve lost only low frequencies, and I hear background noises amplifieds. It’s hard to tell, I hear like through a blown speaker, I hear the message, and also distortion.

I got tinnitus also but now is at very low volume so it does not disturb me much, but distortion does. If I plug my bad ear I realize how much noise it makes. I wonder if this sounds that my ear amplifies will ever end… It’s now four months since the onset. And I feel that I’m not improving anymore…
I’ve got some random clicking in my ear… did you have that?

You said “follow up 15 months later”, when do you think you stopped improving?

Thanks and take care.

Hi Everyone,

I am experiencing the same as the original post.

Lost in low frequency and high frequency, let’s say about 35% [if I have to put a number to it]
I have this humming sound in the ear, which is a bit upsetting in evenings and early mornings.

This has been going on for about 1-2months. I have been on three courses of cortisone since.

First course of corrtisone.This took away the humming sound and hearing returned to normal.
However, about a week after the pills ran out the humming returned and the low and high frequency loss with it.

I went to an ENT which prescirbed another course of cortisone and anti-viral medicine which yet again made the humming
sound go away, and hearing returned to normal. But, again, a week after the course was done the humming returned and the low
and high frequencies reduced.

I went back to the ENT. He gave one look and said that it has to be menier’s disease…and prescribed another course of
cortisone, but a bit shoter than the previous. He also prescribed SERC which is very expensive, [south africa]R720 for a month.
As previously explained, humming went away and hearing returned to normal. But…as before, a week after the course was done
the humming returned and the said frequencies dropped.

I am not entirely convinced that it’s menier’s disease, so I am going for a second opinion. I have no virtigo or nausea.

Has anyone experienced the same as which I am, where cortisone works, but after a week the symptoms return ?
I would truly appreciate some advise

Thanks.

2014-04-03 - UPDATE ON THE ABOVE ISSUE:

Hi All,

I know that people ussually only complain and never come back to provide solutions.
Here is my solution which is currently working for me.

After going for an MRI to check if I’ve got tumours [which I don’t luckily], they found that
I have maxillary antrum mucous retention on the left side, and partial opacification of right mastoid air cells.

After this, I found something on the net with regards to the above: [here is the link]

Child With Hearing Loss. MRI Shows Moderate Opacification Of Left Mastoid Air...5

We had an MRI done on our 8 yr old because of newly diagnosed hearing loss , low and mixed frequency. His MRI says moderate opacification of left mastoid air...

“Opacification in sinuses s/o chronic sinusitis1 and yes its a main cause for hearing loss. As it spreads to middle ear through eustachian tube, causing middle ear effusion2 and changes of inflammation in mastoid antrum.
Needs topical nasal steroidal spray like mometasone nasal spray2 and gromet if impedance audiometry s/o middle ear effusion.”

Here they recommend nasal steroidal spray. I got Avamys which is exactly this.
I used the spray and a week afterwards the low frequency hum stopped. Hearing returned
almost to what it used to be.

I hope this helps someone else in the right direction.

If the above doesn’t work, I suggest that you truly accept what is happening to you, only then can you move forward. I
accepted the fact that it might or might not heal…and I changed for the better. Luckily the spray helps.

Cheers

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