EXCLUSIVE: International Deaf day: The correlation between hearing loss and COVID19 according to an expert
Long term complications associated with COVID19 are emerging a year and a half after the onset of the COVID19 pandemic caused by SARS-CoV-2. These include risk of stroke and myocardial infarctions [heart attacks], permanent lung damage, neurological disorders, disseminated fungal infections in the lung, skin and the dreaded black fungus [rhino-orbital-cerebral mucormycosis].
Sudden sensorineural hearing loss [SSNHL] is a condition in which there is sensorineural hearing loss of more than 30 dB in at least 3 consecutive frequencies over 72 hours.] Patients complain of sudden and significant loss of hearing. Other symptoms associated may be ringing sound in the ear, feeling of blocked or clogged ears and giddiness. The causative factors include vascular stress-causing diminished blood supply to the nerves and some viruses.
ENT professionals are reporting increasing numbers of patients with SSNHL in patients suffering from COVID19. This can occur simultaneously with the COVID19 infection or even months or years later in these patients. Early identification is essential. A pure tone audiometry test is done for accurate assessment of hearing in different frequencies. MRI of the brain is essential to rule out other causes of sudden hearing loss including tumours in the cerebellopontine angle. Treatment includes a course of steroids given orally or via intratympanic injection into the eardrum, vasodilators to improve blood supply to the nerves and multivitamins. Pure tone audiometry test is repeated every 3 days to monitor the improvement of hearing. Recovery of hearing depends on the early detection and initiation of treatment. Some patients may have an incomplete recovery of hearing and will need hearing amplification with the help of hearing aids lifelong.
A 32-year-old male patient came with complaints of a sudden decrease in hearing and ringing in both ears 3 months after recovering from COVID19 infection. Pure tone audiometry revealed a severe sensorineural hearing loss in both ears. The patient was admitted and started on injectable steroids, vasodilators and multivitamin injections.
There was no other comorbidity or cause of hearing loss identified. The patient had improvement in symptoms and documented hearing improvement on audiometry and was discharged after 10 days of treatment.
In case of experiencing any symptoms like sudden decrease in hearing, giddiness, ringing sound in the ear, please consult an ENT doctor for evaluation. Use of household remedies like putting oil, garlic, earbuds etc to clean the ear can result in infection and damage to the external ear. Any delay in seeking professional help also results in irreversible damage as the medicines work best when treatment is started early.
In this post-pandemic world, where schools, offices and meetings are online, most members of a family including children are using earphones or headphones for significant amounts of time in a day. One should invest in good quality earphones with a soft rubber tip of the right size that doesn’t hurt the ear canal. The volume should at the lowest setting where one can comfortably hear the conversation. Listening to earphones/ speakers at high volumes for a long period of time will cause permanent damage to hearing. Use of earbuds and any sharp objects to clean the ears is not recommended. Eardrops should be instilled only on the advice of a qualified practitioner.
About the author: Dr Milind Navlakhe, ENT Surgeon, Lead- Mucormycosis Clinic, Global Hospital, Parel, Mumbai
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