Woken up with muffled hearing? Don’t just assume it’s just ear wax, it could be something far worse

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Waking up one morning, Leesa Barrell was alarmed to find that everything seemed very different.

‘It felt like somebody had put a brick wall up against my right side,’ she says. ‘I called out to my husband Lee and when he replied I could only hear his voice in my left ear.’

Leesa Barrell (pictured) woke up one morning unable to hear out of her right ear

Initially, Leesa, 45, who lives in Norwich with Lee, 49, a school caretaker, and their son Ashlee, 12, thought the problem was probably caused by a wax blockage and would correct itself within a few days.

But when it didn’t, a week after her first symptoms she went to see her GP and was referred to an ear, nose and throat consultant. The specialist dropped a bombshell — she had lost the hearing in her right ear, possibly for good.

‘At that point I became very tearful. I was so worried my hearing would never return,’ she says. Leesa, a finance assistant, was even more overwhelmed when doctors could not explain why it had happened.

Leesa is one of up to 6,000 adults a year estimated to develop idiopathic sudden sensorineural hearing loss, or unexplained hearing loss, that usually develops suddenly, or within three days, usually in one ear.

Often, sudden hearing loss can be attributed to infections, certain medications, head injuries and meningitis, because these can all affect the inner ear. But in some cases, such as Leesa’s, there is no clear explanation.

The hearing organ, the cochlea, is found deep in the inner ear. It is filled with fluid — when soundwaves enter it, the fluid moves and tiny hair cells then trigger signals to the auditory nerve, which passes the signals to the brain.

These are recognised as sounds, allowing us to hear.

Sensorineural hearing loss is down to problems in the inner ear or with the auditory nerve.

The other type — conductive hearing loss — occurs when something has physically blocked transmissions of sound, such as wax. ‘Eighty-five per cent of the time no one ever knows why sudden sensorineural hearing loss occurs because we can’t get to the inner ear to examine it without risking damaging it, or damaging the brain,’ says John Phillips, the consultant ear, nose and throat surgeon at Norfolk and Norwich University Hospital Foundation Trust who treated Leesa.

The most popular theory is that it’s caused by a virus damaging the nerve in the inner ear.

Another is that a blood clot blocks a blood vessel that leads to the inner ear.

A benign tumour on an inner ear nerve may also cause sudden hearing loss — but this is rare. Whatever the cause, losing your hearing suddenly can be ‘very traumatic’ says Mr Phillips.

‘Hearing loss usually occurs in one ear so people get scared it will happen in the other ear, too. They often get balance problems because the inner ear contains the balance organ, the labyrinth, too.

Leesa (pictured) initially assumed that the problem was caused by a wax blockage and that it would correct itself within a few days

‘Losing balance function on one side can make someone feel disorientated before the brain eventually adapts.’

And the damage is often permanent. One year after sudden hearing loss, a third of patients don’t recover any hearing, a third recover fully and the remainder have some hearing loss.

Waking up one morning having suddenly lost your hearing is considered a medical emergency and, if this happens, you should see a doctor that day, advises Mr Phillips.

It may be hard for patients to distinguish a genuine emergency from the muffled hearing that comes with a cold, so see a GP if in doubt. Steroids are currently the only treatment option to help patients regain some hearing — they can improve the outcome, in some cases, if taken within two weeks and are thought to help by calming inflammation.

They used to be given orally, but the latest thinking is to inject steroids directly into the eardrum.

‘If someone loses all their hearing, cochlear implants can cost up to £40,000, so prevention of permanent deafness is key,’ says Mr Phillips.

A study in the New England Journal of Medicine found there is ‘less recovery of hearing when treatment is delayed’.

It’s also less likely to return in under-15s and over-65s, although it’s not known why, as well as in people who suffer from vertigo or who had poor hearing beforehand.

Thankfully, Leesa’s hearing has partially returned — which is likely to be down to her seeking medical help quickly.

When she saw Mr Phillips, a week after her symptoms appeared, he prescribed a three-week course of steroid tablets. ‘On the fifth day of the course I started to hear a muffled, squeaky noise through my right ear,’ she says.

‘I had a couple of side-effects — shakes and tiredness — from the drugs, but it was worth it. Without them I could have been deaf in that ear my whole life.’

A couple of weeks after finishing the course she regained 50 per cent of her hearing in her right ear, but nonetheless needed to have a hearing aid fitted.

Leesa (pictured) was given a three week course of steroid tablets and she eventually regained 50 per cent of the hearing in her right ear although she still needed to have a hearing aid fitted

This has helped ‘a lot’, she says, though she admits: ‘I feel much too young for one.’ A nasty consequence of her hearing loss has been severe tinnitus (in which a phantom ringing or buzzing is heard) in her right ear. ‘It’s the worst part of the whole experience, like a constant waterfall in my ear.’

People with hearing loss often develop tinnitus, explains Mr Phillips. ‘Because the brain isn’t receiving sound from the ear it tries to strain to hear more and so picks up sounds that don’t have a genuine source.’

Hearing aids are usually the first option. People with severe or profound hearing loss, especially in both ears, may find hearing aids don’t help.

One option is a cochlear implant — an electronic device that is surgically implanted that does the work of the damaged section of the ear.

Helena Martins had one fitted in October 2013. The 41-year-old marketing manager, from South-West London, suddenly lost hearing in one ear in 2009 and the other in 2010, both overnight.

This happened after she was diagnosed with Meniere’s disease, which is caused by pressure within the inner ear and causes vertigo, tinnitus and hearing loss.

‘I was in complete panic when I woke up one day in 2010 and everything was awfully quiet. I saw my partner’s lips move, but I couldn’t hear any words coming out. I knew that my hearing had completely gone.’

People with Meniere’s often develop total hearing loss. Helena tried hearing aids, but they became ineffective after a few months and so a cochlear implant became her only option.

‘After it was turned on I could hear people’s voices again — I was so happy,’ she says.

As for Leesa, she has learned to live with her hearing loss. ‘Without my husband and son’s support this would have been much worse,’ she says.

For further information and support, go to actiononhearingloss.org.uk