Sudden hearing loss: How to identify the cause promptly

Richard Hsu, Samuel C Levine

Research output: Contribution to journalReview articlepeer-review


Sudden hearing loss can be categorized as conductive or sensorineural. Causes of conductive hearing loss include cerumen impaction, a foreign body, and otitis media with effusion. Sensorineural hearing loss may be caused by infection, vascular disorders, temporal bone fracture, and certain drugs. When taking the history, inquire about the time course of the hearing loss; additional symptoms and signs, such as vertigo, pressure in the ear, and fever; and recent head trauma, medication use, air travel, and diving. In addition to evaluating the middle ear with an otoscope that has a pneumatic head, consider performing a Weber test (with a standard 512-Hz tuning fork) to differentiate between conductive and sensorineural hearing loss. If you suspect sensorineural hearing loss, obtain an audiogram as early as possible. Other studies may include an erythrocyte sedimentation rate, white blood cell count, viral titers, lipid and coagulation profiles, and CT scan of the temporal bones.

Original languageEnglish (US)
Pages (from-to)23-32
Number of pages10
Issue number1
StatePublished - Jan 1998


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