Sudden & Permanent Hearing Loss -SSHL?

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carrspaints

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Hi guys, I am following up on a post I made back in 2005 regarding my sudden hearing loss during a dive. 6-years have gone by and I'm really just trying to find out if anyone has experienced what I have, if there have been any developments in understanding or remedying SHL or SSHL, anything that may provide me with a new avenue to persue.

6-Years on from this incident and my hearing remains unchanged, no improvement. My story follows below, I have cut and pasted the same posting I made back then to give you a history of what occurred.

"2005 - I am certified but this was only my 12th dive. I have always had problems equilising ear pressure on decending and sometimes have pushed it when I shouldn't have, i.e. lived with the pressure pain. I sometimes suffered slight hearing loss but nothing major...usually just water in the ears and hearing returned to normal within a few hours.

On this particular dive, I did not experience much of a problem with equilising. Everything seemed 0kay, just slight pressure. About 5 minutes into the dive, I had a sensation of hearing a loud "buzzing" sound (not ringing) that increased in volume and pitch and then died away. I can only describe the sound as almost identical to a lawn mower engine increasing in frequency until the pitch died away. This lasted about 8-10 seconds. I knew something wasn't right as that sensation or sound wasn't one I have experienced before. It wasn't imaginary, it was a real motor-like sound. I carried on with the dive, as there was no pain associated with this, no dizziness. I kinda thought....we'll it's probably like previous dives...nothing to worry about.

When I surfaced 30-minutes later, I was stone deaf in my right ear. I mean stone deaf, not a sound. I was also very dazed....but not dizzy. Kinda similar to a concust or semi concust feeling. That has improved, but 4 weeks later and I still feel a bit dazed. Balance is fine.

Long story short, I went immediately to an ENT specialist in Cancun (I was on holiday in Mexico). He did various test with a tuning fork, headphones, that lamp gadget they use to look in the ear, plus an ear pressure test. He concluded that I had acute hearing loss in the right ear and that the "prognosis was not good". :icon10: :icon10: He suggested I may have suffered a viral infection, a spastic nerve?, or a blood clot that restricted or shut down blood flow to a vital part of the neural hearing system. I am almost certain that my problem is directly related to barotrauma of some description and tried explaining this to him....he seemed to doubt my thoughts. I certainly doubt his.....too much of a coincidence with the problems I have always had with equilising on dives.

I was placed on drugs that included a steriod (Prednisolone 5mg) and hyperbaric chamber treatment to increase oxygen to all parts of the body (not to treat decompression sickness). No improvement.

4 weeks later and I'm back in the UK. There has been slight improvement in hearing over the 4 weeks but as good as useless. With headphones on, I can hear heavy base and drums but distorted and increasing volume seems disproportional to the increase in volume I get in my good ear...i.e., I get about 20% volume increase total in my right as opposed to 100% in my left. I cannot hear anything above 250hz...so no voices, no nothing except for deep, deep tones and they are faint. I cannot make out words when people speak, even when a mobile phone is pressed to the affected ear. I can hear that people are speaking, but since all mid and high range frequencies are gone, it sounds more like rumbling than words.

If anyone can share any information on probable causes, or has had a similar experience, I would be grateful to hear from you. I am especially interested to hear from anyone who had experienced this "lawn-mower" like noise directly before the hearing loss. I'm convinced that barotrauma has damaged something .... that this is not a viral condition. By the way, I had a MRI scan done and the ENT fella called to say "good news, all clear with the MRI"

Any help would be gratefully appreciated"


My hearing is exactly is it was 6-years ago. I understand that this almost 99.9% means it will never improve but I am an eternal optimist and hey, if you don't fight these things, keep abreast of technology, developments, well then it's 101% certain it'll never change. No harm in following up so hope you don't mind me checking.
 
Hi Carrspaints,
Did you get worked up for this after you got home? If so, what were you told?
 
Same year I also lost the hearing in my left ear.
I had done thousands of dives as a guide in the BVI and had been working full time as an instructor for 15 years at this time.
At the time I was living in Florida (still am) and hadn't been diving for 4-5 days and woke up with what I assumed was an infection in my left ear....no pain but no hearing and a "full" feeling in that ear along with a ringing which I took to be the infection in the middle ear.
Since I had health coverage with my employer I went to my GP the same day (normally I would have self medicated with a Z-pack, cipro or amoxy) he had a quick look and didn't see anything and got an appointment with an ENT specialist for the next day.
She could find no sign of an infection either and this is when I first heard of SHL, she couldn't pinpoint the cause (don't think anyone can) but suggested it was either a nerve swelling caused by a virus or a growth in my brain.....but most likley the virus. She said the one chance I had of getting any hearing back would be to take a powerful steroid as soon as possible to reduce the swelling in the nerve BUT I had to have a blood test first.

This is where I'm going to have a bit of a rant about the whole US medical system....I'm originally from the UK and was used to a medical system that was based around patient care and not the almighty dollar.

In order for me to take the steroid, the only thing that could possibly save my hearing, I had to get this blood test asap, and to do that I had to go to a medical test lab that accepted my health insurance (Humanna).
The ENT specialist didn't do blood work so I was sent on my way with an address of a lab and a bit of paper detailing what blood test was needed.
Now, I'm calm and easy going by nature but I had just been told that I might have brain cancer and I was probably going to loose half of my hearing and they couldn't give me the only medication that might save it.
The test lab I was sent to was situated in a strip mall about 4 miles away but they had just dropped Humanna and wouldn't take my blood. I'm now starting to get frantic as it's already after 4:00 pm.
I have to go back to the ENT doctor and get the address of another lab to do the test. By the time I get to the new lab it's 5:05pm....it's closed. I bang on the door as I can see people inside, but they refuse to open up. I go to the side door where I see staff leaving and plead for them to take my blood....no dice son it's after 5...and of course when I get back the ENT is closed too.
Long and the short of it is it's the following day that I get the blood work done and the day after that before the results come in and I can now get the prescription from the ENT specialist to go to a pharmacy and start taking the steroids which have no effect since the nerve is already dead.
I have a brain scan later that week. No tumor.
Would it have been a different outcome in the UK, where I would have seen a ENT at a hospital that would have done the blood tests on site in a matter of a couple of hours and got the steroids (also from the hospital) the same day and not delayed by 3 days ...... most likely not, but at least I would have had a chance.

To any other US readers (I am one of you too now), please don't keep believing we have the best health care system in the world, it's not, we need to change it, don't be afraid of the word "socialized"(what's Medicare anyway), medicine shouldn't be about making profits for the insurance companies.

Rant over.

To get back to Carrspaints original point I too am in the same situation 6 years later.
95% loss in my left ear, continual ringing/white noise all the time that gets worse in loud environments.
My social life does not include bars and restaurants with music and I avoid situations with allot of ambient noise and I get to practice saying "what?".
I have noticed I'm a little better at telling a direction of a sound, maybe my brain has compensated.
I too would like to know more about SHL.
 
Hi DDM & Fishpie. DDM, I visited a top ENT fella here in the UK as soon as I returned (Private Healthcare)- he ran the same tests, did some blood tests, sent me for a MRI scan etc. This was over a number of days. He couldn't find anything either and could only speculate on the cause. What he seemed certain of though is that a miracle was unlikely. Still, technology moves on as does our understanding of the Human body, which is why I am following up.

Fishpie, I empathise with your situation. I am as good as 100% deaf in my one ear. I too was offered steroids but only after the 10-day hyperbaric chamber treatment I had in Mexico @ U.S. $ 200.00 per session. I only learned of the steroidal treatment on return to the UK, too late by then of course.

I too have to avoid any areas with moderate background noise. Restuarants, bars, any place with moderate noise and I'm forever saying "pardon", "excuse me", "sorry" or just nodding my head when I don't understand a word said, hoping that will get me through the conversation.

I do find it wierd how greed for money overrides health considerations in some countries. Brits here ( I am not British) do complain alot about the health system. But you do get treated and don't need to write a cheque with several zeroes on it.

Let's hope we can get some information from others that mayprovide some hope, or at least some understanding on what went wrong and why it can't be fixed, if that is the case.
 
Carrspaints,

It's difficult to say exactly what happened to you. The ENT physician in Mexico seemed to think that it was not diving-related and treated it like an embolic event (think of it as a stroke that happens in the inner ear), which was the rationale for putting you in the chamber. Sudden sensorineural hearing loss of that type was just approved by the UHMS (Undersea and Hyperbaric Medical Society) as a specific indication for hyperbaric treatment.

I'm loathe to armchair quarterback a physician from behind a computer, but I'd say that given your history of difficulty equalizing and the fact that you experienced symptoms during a pressure change (i.e. descent), I tend to agree with your assessment - it's possible that you suffered from inner ear barotrauma.

In either case, whatever you have right now is probably what you're going to have. There are cochlear implants, but I'm not sure you would be a candidate considering that you can still hear out of your other ear. When is the last time you were evaluated by an ENT?
 
Hi DDM. Yeah, you're probably right, I probably won't have any improvement to my deaf ear. I have read up on Cochlear implants and my understanding is that the sound heard is very different. Apparently it requires a lot of therapy/training for one to interpret the audio signals the brain receives.

I haven't been back to an ENT in 6-years - too scared he'll tell me my hearing in the other ear is degrading...the number of times I struggle to hear does make me wonder.

My diagnosis was ideopathic. You are spot on with your point about the "mini-stroke" though, that is one of the possibilities strongly suggested by the Mexican ENT. It's possible, but I am convinced it's inner ear barotrauma. I know the ear and neuro connections are little understood but, who knows, perhaps they will find away to explore here in the future without having to undertake extensive and painful surgical procedures that could create other issues.
 
I have 560 dives just about everywhere in the world except the Indian Ocean. I was diving in Vanuatu on March 5 of 2012. Did a deco dive on the wreck of the Calvin Coolidge near Luganville. Was down to about 130 feet in the forward hold of the Coolidge at the lowest point. This was the only dive on this trip although I had been snorkeling and continued to snorkel after the dive. I free dive to twenty feet or so when I snorkel, but I was able to equalize on all free dives. On the SCUBA dive, I had no difficulty getting down, no difficulty on the dive, and no noticeable difficulty on the decompression stops. I was diving with rented equipment with bars instead of psi and meters instead of feet. I did not have my own dive computer. The divemaster had a dive computer and kept track of our deco stops. When I came up, I could not clear my right ear. We went to the dive shop for the dive interval between the Coolidge and Million Dollar Point dives. At the dive shop, I was not hearing at all from my right ear and I was acting somewhat hazy (suspected the hearing loss might be related to DCS), so they put me on oxygen for a half an hour and the dive shop would not let me do the second dive. I did not have any balance issues and have not had any balance or vertigo symptoms. They took me back to the cruise ship. I can wiggle my finger around in my right ear and get another 20% back for about 3 minutes, but that means that I have to keep wiggling my finger in my ear which is not always socially acceptable.

Got back to the Seattle on Mar 14, 2012 and immediately got an appointment with my GP. There was no damage to my eardrum. He gave me the Afrin/Flutisone/Sudifed and had me come back in a week. No positive result, so he sent me to an ENT doctor. Before seeing the ENT doctor, I had the hearing tests and they concluded that the middle ear was not the culprit. It looks like it is somewhere in the inner ear. The ENT consulted with Dr **** (DAN doctor) from Seattle's Virginia Mason hyperbaric chamber. They gave me a 33% chance of it recovering, a 33% chance that I will get some back, and a 33% chance that there will be no improvement. He also mentioned that they can cut around my eardrum and look around in the middle ear to see if there is anything amiss. It doesn't sound too appealing, but if there is a cut somewhere in the inner ear they might be able to repair a hole or cut. The ENT doctor gave me a prescription for steroids and I have been on those for two weeks with no noticeable improvement other than making me very jittery. So far there is no change and no improvement.

My symptoms sound somewhat like carrspaints and Fishpie, so if anyone would like to comment, that would be terrific. I did discuss with the ENT doctor about my ability to wiggle my finger in my ear and get some back. That would imply at least a partial mechanical problem, like the stirrups being disconnected from the cochlea, or something like that. I have another week and a half to go on the steroids, but since there has been no improvement and there appears to not be a chance of further improvement, surgery might be the way to find out if there is anything in the middle ear that could be affecting the loss of hearing and maybe a little possible improvement.
 
Hi guys,

I am not a scuba diver and suffered from similar condition.

I was wondering if you are still going to swimming pools or going on very short dive swimming pool level dives or did you cut on everything water-related (I guess not ) ?
 
Fish...& Carrs.....

Do you have bone conduction hearing? One test you may have had was your ENT doc applied a struck tuning fork to your skull. If you heard the tone of the tuning fork in your "deaf" ear then this should indicate you have sensory input through your cochlea. There are a couple of companies producing bone anchored hearing aids which might help in your situation(s). These are much less surgically intrusive than cochlear implant devices.

I have very little air conduction hearing in my right ear due to repeated juvenile infections and two tympanoplasties. However my cochlea was intact. I was able to qualify for a bone anchored hearing aid. This involves placement of a post in your skull, proximal to the bad ear (yes they drill a hole and put a screw in it). A receiver/transducer snaps onto the post and vibrates. This transmits the aural signal through the bone to the cochlea, thence to your brain.

Carrs... avoiding follow-up with your doctor will not prevent future problems. In fact it may result in future problems. Don't be a wuss.

I am not a doctor so this qualifies as a free armchair diagnosis. You get what you pay for..................
 
So I was normally swimming and it was all good.I have actually read you can use ear plugs both for swimming and diving which are used mostly by people who are prone to infection but which, I suppose, can help or nullify the effect of the pressure (I am actually going to learn to swim, so these are all first times for me).
 

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