The incidence rate has increased by more than 3 times! How can a healthy young person suddenly become deaf?

In recent years, many otolaryngologists have found that "sudden deafness" has a trend of becoming younger and younger. The common expression of patients coming to the hospital is "suddenly I can't hear anything", or "my ears are buzzing, and I went to the hospital for a check-up and found that my hearing was damaged", and some also said that they would have symptoms of "dizziness and inability to open their eyes". According to the "Chinese Journal of Otolaryngology Head and Neck Surgery", the incidence of sudden deafness in China has increased by more than 3 times from 2005 to 2020, of which people aged 20 to 40 account for more than 60%. So what exactly is this disease? Why is the proportion of young people suffering from it increasing year by year? Today is National Ear Care Day, let's talk about it in detail.

What abnormalities will occur if you suffer from sudden deafness?

Sudden deafness, also known as sudden sensorineural hearing loss (SSNHL), is a disease that causes rapid hearing loss in a short period of time. It is also a common disease in otolaryngology, with a high prevalence rate and a great impact on the quality of life of patients.

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Once you suffer from sudden deafness, you may experience the following symptoms:

① Sudden hearing loss: usually unilateral, but in a few cases bilateral hearing loss may occur.

②Tinnitus: About 90% of deafness is accompanied by tinnitus symptoms. The tinnitus is persistent and can manifest as high-frequency tinnitus (whistling sound) or low-frequency tinnitus (mechanical roaring sound).

③Feeling of ear fullness and stuffiness: About 50% of patients with hearing loss experience a feeling of ear fullness and stuffiness, which is persistent and cannot be improved by swallowing, changing body position, etc.

④ Auditory hypersensitivity or hearing loss: Deaf patients may be allergic to loud sounds, causing physical discomfort and phonophobia.

⑤ Abnormal sensation around the ear: common in patients with complete deafness.

In addition to ear symptoms, there may be other physical symptoms:

① Vertigo or dizziness: About 30% of patients with sudden deafness experience vertigo or dizziness, which is related to the damage to the inner ear function affecting the vestibular balance organ.

②Some patients will experience mental and psychological symptoms, such as anxiety, sleep disorders, etc.

Why does “sudden deafness” occur in young people?

The human ear is divided into three main parts: the outer ear, the middle ear, and the inner ear.

The main function of the outer ear and the middle ear in hearing is to transmit the vibration of sound to the inner ear through mechanical conduction, and then the inner ear converts the physical vibration of sound into electrical nerve signals and transmits them to the auditory center of the brain through nerves. The inner ear contains an important organ, the cochlea, which is filled with lymph and a large number of hair cells, which are important components for converting sound signals.

Original by Tang Xinyue Popular Science China

March 3, 2025 14:12 Beijing

In recent years, many otolaryngologists have found that "sudden deafness" has a trend of becoming younger and younger. The common expression of patients coming to the hospital is "suddenly I can't hear anything", or "my ears are buzzing, and I went to the hospital for a check-up and found that my hearing was damaged", and some also said that they would have symptoms of "dizziness and inability to open their eyes". According to the "Chinese Journal of Otolaryngology Head and Neck Surgery", the incidence of sudden deafness in China has increased by more than 3 times from 2005 to 2020, of which people aged 20 to 40 account for more than 60%. So what exactly is this disease? Why is the proportion of young people suffering from it increasing year by year? Today is National Ear Care Day, let's talk about it in detail.

What abnormalities will occur if you suffer from sudden deafness?

Sudden deafness, also known as sudden sensorineural hearing loss (SSNHL), is a disease that causes rapid hearing loss in a short period of time. It is also a common disease in otolaryngology, with a high prevalence rate and a great impact on the quality of life of patients.

Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.

Once you suffer from sudden deafness, you may experience the following symptoms:

① Sudden hearing loss: usually unilateral, but in a few cases bilateral hearing loss may occur.

②Tinnitus: About 90% of deafness is accompanied by tinnitus symptoms. The tinnitus is persistent and can manifest as high-frequency tinnitus (whistling sound) or low-frequency tinnitus (mechanical roaring sound).

③Feeling of ear fullness and stuffiness: About 50% of patients with hearing loss experience a feeling of ear fullness and stuffiness, which is persistent and cannot be improved by swallowing, changing body position, etc.

④ Auditory hypersensitivity or hearing loss: Deaf patients may be allergic to loud sounds, causing physical discomfort and phonophobia.

⑤ Abnormal sensation around the ear: common in patients with complete deafness.

In addition to ear symptoms, there may be other physical symptoms:

① Vertigo or dizziness: About 30% of patients with sudden deafness experience vertigo or dizziness, which is related to the damage to the inner ear function affecting the vestibular balance organ.

②Some patients will experience mental and psychological symptoms, such as anxiety, sleep disorders, etc.

Why does “sudden deafness” occur in young people?

The human ear is divided into three main parts: the outer ear, the middle ear, and the inner ear.

The main function of the outer ear and the middle ear in hearing is to transmit the vibration of sound to the inner ear through mechanical conduction, and then the inner ear converts the physical vibration of sound into electrical nerve signals and transmits them to the auditory center of the brain through nerves. The inner ear contains an important organ, the cochlea, which is filled with lymph and a large number of hair cells, which are important components for converting sound signals.

Image source: sohu.com

Because the hair cells of the inner ear are very fragile, any external or internal stimulus or environmental change will affect the function of the hair cells, and even cause damage and necrosis. For example, changes in lymph pressure; insufficient blood supply caused by spasm/embolism of inner ear capillaries; damage caused by viral infection; blood pressure fluctuations and hormone changes caused by psychological factors such as mental stress, emotional fluctuations and tension, etc.

Unfortunately, after decades of research, the exact cause and pathogenesis of this disease are still unclear, and the diagnostic standards and treatment plans of countries around the world have not yet been unified. Currently, there are two theories generally recognized by scholars:

1

Inner ear vascular embolism/spasm theory

Viral infection is a common cause of sudden deafness. This theory believes that viruses invade the cochlea through the blood and cause local infection, which in turn causes damage to the vascular endothelium and edema, and the blood is in a hypercoagulable state, causing thrombosis, affecting the inner ear function and causing hearing loss. Some scholars believe that hearing will be affected when the blood vessels supplying the inner ear have spasms, embolism, or when the blood vessels are compressed, narrowed, bleeding, and blood coagulability increases. Diseases such as hypertension, diabetes, and hyperlipidemia affect the blood supply of the whole body, and can also cause insufficient blood supply and oxygen supply to the inner ear, becoming a high-risk factor for sudden deafness. In addition, psychological factors such as mental stress, emotional fluctuations, and tension lead to increased concentrations of related active substances such as adrenaline in the blood, directly or indirectly causing a series of inner ear microcirculation disorders such as capillary spasms and thrombosis, which can also lead to the occurrence of sudden deafness.

2

Immunology

In addition to the vascular theory, some experts and scholars have proposed the immune damage theory, which believes that various factors such as viral infection, mental stress, and emotional fluctuations can cause abnormal function of the hypothalamus-pituitary-adrenal axis in the human body, and at the same time, under the joint action of the body's inflammatory response, participate in the occurrence and development of the disease.

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It is worth mentioning that the "Guidelines for the Treatment and Diagnosis of Sudden Deafness" also mentioned that mental stress and poor sleep quality are likely to be the main indirect causes of sudden deafness. Many contemporary young people have high work pressure, mental tension or irregular sleep. Especially some highly educated people and mental workers are more likely to be in a bad mood and abnormal sleep state, so they need to be vigilant. People with the following diseases need to pay special attention: ① Diabetic patients: Diabetic patients have insulin resistance, which leads to microvascular lesions and capillary damage, thereby increasing the risk of sudden deafness. ② Patients with cerebrovascular diseases: Patients with cerebrovascular diseases are often accompanied by varying degrees of atherosclerosis. Sudden deafness is a local ear manifestation of systemic organ microcirculation disorders. ③ Patients with colds: Colds are usually caused by viral infections, and viral invasion of the inner ear is one of the important causes of sudden deafness. ④ Patients with abnormal cholesterol (TC)/homocysteine ​​(Hcy): Abnormal TC indicates disordered blood lipid metabolism, which is an important cause of atherosclerosis and microcirculation disorders. Abnormal Hcy is also related to atherosclerosis. Both increase the risk of inner ear microvascular dysfunction.

If you suffer from sudden deafness, can your hearing be restored?

Regarding the treatment of sudden deafness, the latest guidelines recommend that there is a big difference in concepts with the current clinical practice in my country. Chinese clinicians generally believe that once sudden deafness is diagnosed, active medical intervention should be carried out to rescue hearing. Once the treatment opportunity is missed, the possibility of self-recovery is small and may become permanent deafness. After conducting a large amount of evidence-based medical literature research, the guidelines believe that although the cause of sudden deafness is unknown, it has a certain degree of self-healing, with a self-healing rate of about 30%~60%, and self-healing generally occurs within 2 weeks after onset. The possibility of self-healing is related to the degree and location of hearing loss. The smaller the damage, the greater the possibility of self-healing. Hearing loss with low-frequency decrease is more likely to heal than hearing loss with high-frequency decrease and full-frequency decrease. The general outcome of obvious recovery within the first 2 weeks is better, and patients with small hearing changes within 2 weeks are unlikely to have significant recovery in the later stage. Patients with simple hearing loss are more likely to recover than those with hearing loss and dizziness. Therefore, if abnormal symptoms are found, you must seek medical attention in time and perform hearing restoration under the guidance of a doctor.

1

Long-term hearing management

Sudden hearing loss can be frightening and may cause embarrassment, frustration, anxiety, insecurity, loneliness, depression, and social isolation. However, simple deafness is not life-threatening and does not affect other organs. Therefore, it is crucial to correctly understand and view the disease. Patients need to fully communicate with doctors to understand the occurrence, development, and possible outcomes of the disease, and seek psychological counseling if necessary.

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Once irreversible hearing loss is detected, hearing rehabilitation should be sought as soon as possible, including counseling and discussion of methods to assist hearing recovery. It is recommended that patients with sudden deafness continue to follow up with hearing tests within 6 months of the initial diagnosis.

2

Artificial hearing intervention

For long-term hearing recovery intervention, it mainly depends on the reconstruction of artificial hearing. According to the severity of hearing loss, there are several options: hearing aid fitting, cochlear implant or artificial brainstem hearing implant. In summary, sudden hearing loss needs to be taken seriously. It is crucial to seek medical treatment, check in time, and start treatment as soon as possible. Diseases such as diabetes, cerebrovascular disease, dyslipidemia, long-term sleep disorders, staying up late, bad mood, and greasy, sweet and other living and eating habits are risk factors for sudden deafness. Daily health management and developing good living and eating habits are the best choices to prevent the occurrence of the disease. For patients with the disease, fully understanding the disease, sufficient doctor-patient communication, and jointly deciding on treatment plans are the correct diagnosis and treatment methods. Do a good job of emotional management, actively promote hearing and social rehabilitation, help yourself integrate into society faster, and resume normal life is the ultimate goal of everyone.

References

[1] Lei Lihong, Ding Xiaoli, Xu Gaiping, et al. Analysis of case characteristics and risk factors of sudden deafness[J]. South China Journal of Preventive Medicine, 2022, 48(5): 539-542.

[2] Feng Wenjing, Liu Bo, Peng Xiaoxia, Lian Nengjing, Niu Leifang. Study on the risk factors of sudden deafness[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2008, 15(6): 343-345.

[3] Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Chinese Society of Otorhinolaryngology Head and Neck Surgery. Guidelines for the diagnosis and treatment of sudden deafness (2015) [J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50(6): 443-447.

[4] Li Hao, Zhu Zunyi, Xie Han. Interpretation of the treatment plan of the American AAO-HNSP Guidelines for Sudden Hearing Loss (2019 Update)[J].

[5] Liu Peng, Zheng Yun, Zhong Ping, Lu Jingzhe. Interpretation of the 2019 American Clinical Practice Guidelines for Sudden Deafness (Updated Edition)[J]. Journal of Audiology and Speech Pathology, 2020, 28(4): 480.

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Author: Tang Xinyue, otolaryngologist

Review | Pan Chunchen, deputy chief physician of the Department of Otolaryngology, The First Affiliated Hospital of University of Science and Technology of China