A patient reporting sudden loss of hearing in one ear, often with fullness or tinnitus, is commonly told it is wax or a cold. Look in the ear; if the canal is clear, do a tuning fork test. With Weber lateralising to the good ear and Rinne positive in the affected ear, the loss is likely sensorineural. That pattern warrants same-week audiometry and ENT review, because treatment is most likely to help when started early, and an MRI is usually needed to exclude a retrocochlear cause.
- Examine the ear canal before attributing sudden hearing loss to wax or infection.
- Use Weber and Rinne tests to separate conductive from sensorineural loss.
- Refer suspected sudden sensorineural loss for audiometry and ENT review within days.
- Expect an MRI to exclude a retrocochlear cause in unilateral sensorineural loss.
Why it matters
Delay is the commonest avoidable failure in sudden sensorineural hearing loss.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ent & head and neck surgery, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free