Sudden hearing loss

At a glance

  • Sudden hearing loss (or 'sudden deafness') is an unexpected, rapid loss of hearing.
  • It usually only affects one ear.
  • It can also cause sounds in the ear (tinnitus) or dizziness.
  • Your hearing sometimes comes back by itself.
  • But treatment is recommended for severe or long-term hearing loss, normally with medication.


Photo of a young man holding his ear

If you suddenly notice that your hearing has got worse, like somebody has turned the volume down, you might have sudden hearing loss.

Also called sudden deafness or sensorineural hearing loss, it usually only affects one ear. Some people hardly notice the loss of hearing, and others hear much worse or even nothing at all in that ear. In many cases, it’s just certain frequencies that can't be heard. For instance, you may no longer hear higher-pitched sounds like children's voices but can still hear lower-pitched sounds like an engine. Other symptoms may occur too, like sounds in the ear (tinnitus) and dizziness.

The causes of sudden hearing loss are not known. Because of this, it is also called idiopathic (unexplained) sudden hearing loss.

Sudden hearing loss doesn't always need to be treated. Mild sudden hearing loss goes away again on its own in some people. More severe or long-term hearing loss is treated with steroid medications. If you still have hearing problems after that, things like hearing aids can help.


The main sign of sudden hearing loss is unexpectedly not being able to hear properly. It usually only affects one ear. The hearing loss can be very mild and might even go unnoticed. But it may be more severe or even cause deafness.

Sometimes the hearing loss affects one or more frequency ranges. Then it's harder to hear high, middle and/or low frequencies. It is rare for all ranges to be affected.

Other possible symptoms include:

  • Tinnitus on the affected side
  • Dizziness
  • Hearing double (diplacusis): This happens if the affected ear 'hears' sounds at a higher or lower pitch than the healthy ear.
  • Being very sensitive to sound (hyperacusis): Quiet or slightly louder noises are perceived as being unpleasantly loud.
  • Pressure on the ear
  • Feeling like the ear is clogged (full)
  • Fuzzy or numb feeling in the ear

The hearing loss can make it more difficult to follow conversations and talk with other people. If it causes tinnitus too, that can add to the distress. So sudden hearing loss can greatly affect your quality of life, depending on the symptoms.


When sudden hearing loss occurs, the inner ear can no longer process the sound waves properly (inner ear hearing loss). It is not clear why that happens.

Illustration: Structure of the ear

It is thought that infections and stress might play a role, but there's no proof for either. Some experts believe that sudden hearing loss is caused by decreased blood supply to the inner ear.

Less commonly, inner ear hearing loss is caused by other diseases such as Menière’s disease, or a benign tumor in the inner ear or on the auditory (hearing) nerve. Loud noises such as a bang can also damage the inner ear. This kind of damage is known as acoustic trauma. Earwax may build up and block the ear canal, too, causing you to hear worse. But doctors can easily remove the earwax.


Every year, an estimated 3 in 1,000 people in Germany see their doctor because of sudden hearing loss. It is most common in adults between the ages of 40 and 60. Children very rarely have sudden hearing loss.

Outlook and effects

As the name suggests, sudden hearing loss typically develops quite quickly. After that, various things may happen:

  • Some people can hear much better again after a few hours or days, and their hearing often returns completely. The chances of that happening are good if the hearing loss is only mild and mainly affects low or mid-range frequencies. Full recovery is also more likely if there is no dizziness. Experts estimate that sudden hearing loss goes away by itself in 32 to 65 out of 100 people.
  • Others take medications and can then hear better again after a few days or weeks.
  • But sometimes people's hearing doesn't get better, even after treatment, and they are hard of hearing over the long term.
  • Or their hearing gets better, but the tinnitus doesn’t go away.

People who have sudden hearing loss in the low or mid-range frequencies are more likely to have sudden hearing loss again.


People who have sudden hearing loss are typically referred to an ear, nose and throat (ENT) doctor. The doctor will first ask you about your symptoms and any possible causes of the hearing loss, such as a loud bang. They will then do various ear examinations to see how severe the hearing loss is and to look for possible causes. These may include:

  • Otoscopy (looking into the ear using a special instrument)
  • Hearing tests
  • Examination of the eardrum and middle ear using a measuring probe
  • Examinations of the auditory (hearing) nerve and sensory hair cells in the inner ear

Further examinations are usually done to find out whether another medical problem has caused the sudden hearing loss. These include blood tests and imaging procedures such as (MRI) scans. It is particularly important to thoroughly look for other causes in children because sudden hearing loss is very rare in children.

If no cause for the hearing loss can be found, the problem is diagnosed as “idiopathic sudden hearing loss.”


Sudden hearing loss doesn't always have to be treated. If the hearing loss is only mild and hardly causes any problems, doctors usually recommend waiting a few days. That’s because some people’s hearing gets better without treatment.

But quick treatment (within 1 to 2 days) is recommended if

  • the hearing loss is severe and/or distressing,
  • you already have another ear problem, or
  • you also feel dizzy.

If the dizziness is very bad, it’s a good idea to see a doctor the same day.

Treatment for sudden hearing loss normally involves using steroid medications (cortisone). These medications reduce and are usually taken as tablets for several days. If treatment with tablets doesn’t help or isn’t possible, the drug can be injected into the middle ear under local anesthetic.

But there aren't enough reliable studies to say how effective these medications are in the treatment of sudden hearing loss. Because of this, people who are given steroids for sudden hearing loss usually have to pay for the treatment themselves.

If treatment with steroids doesn’t help enough, other approaches such as can be tried. For similar reasons, they are not covered by statutory health insurers either (in Germany).

If hearing loss or even deafness last a long time, a hearing aid or cochlear implant may be considered.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. But you can also go straight to an ear, nose and throat (ENT) specialist if you have sudden hearing loss. Read about how to find the right doctor, how to prepare for the appointment and what to remember.

If the hearing loss doesn't get better, you can join a support group to meet other people with similar symptoms, feelings and practical problems. People living in Germany can look for a suitable group in their area on the German-language website of the National Contact and Information Office for the Encouragement and Support of Self-help Groups (Nationale Kontakt- und Informationsstelle zur Anregung und Unterstützung von Selbsthilfegruppen, NAKOS).

Brandes R, Lang F, Schmidt R. Physiologie des Menschen: mit Pathophysiologie. Berlin: Springer; 2019.

Chandrasekhar SS, Tsai Do BS, Schwartz SR et al. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg 2019; 161(1_suppl): S1-S45.

Deutsche Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie (DGHNO-KHC). Hörsturz (Akuter idiopathischer sensorineuraler Hörverlust) (S1 guideline, under revision). AWMF-Registernr.: 017-010. 2014.

Lenarz T, Boenninghaus HG. Hals-Nasen-Ohren-Heilkunde. Berlin: Springer; 2012.

Plontke SK, Meisner C, Agrawal S et al. Intratympanic corticosteroids for sudden sensorineural hearing loss. Cochrane Database Syst Rev 2022; (7): CD008080.

Pschyrembel Online. 2023.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on October 18, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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