Sudden sensorineural hearing loss, developing over up to three days, is often dismissed as wax or a blocked ear. A 512 Hz tuning fork separates the two in a minute: in sensorineural loss, the Weber test lateralises to the better ear; in conductive loss, it lateralises to the affected ear.
Sensorineural loss needs same-day or next-day assessment by ENT, audiometry, and consideration of corticosteroids, which are more likely to help the earlier they start. An MRI to exclude a vestibular schwannoma is part of the work-up for asymmetric loss.
- Examine the ear canal and do a Weber test in anyone with sudden one-sided hearing loss.
- Treat Weber lateralising to the good ear as sensorineural loss until proven otherwise.
- Refer sudden sensorineural loss to ENT the same or next day.
- Arrange audiometry, and imaging for asymmetric loss, as part of the work-up.
Why it matters
Treatment is time-sensitive, and sudden sensorineural loss is commonly misread as a blocked ear.
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