Differential Diagnosis for Acute Unilateral Hearing Loss
- Single Most Likely Diagnosis
- Idiopathic sudden sensorineural hearing loss (SSNHL): This condition is characterized by a sudden loss of hearing in one ear, often without any identifiable cause. It is the most common diagnosis for acute unilateral hearing loss, and prompt treatment with corticosteroids may improve outcomes.
- Other Likely Diagnoses
- Middle ear infection (otitis media): An infection of the middle ear can cause hearing loss, ear pain, and fever. It is a common condition that can be treated with antibiotics.
- Otosclerosis: A condition in which abnormal bone growth in the middle ear causes hearing loss. It can be treated with surgery or hearing aids.
- Acoustic neuroma: A benign tumor that grows on the nerve connecting the inner ear to the brain, causing hearing loss, tinnitus, and balance problems. It can be treated with surgery or radiation therapy.
- Do Not Miss Diagnoses
- Stroke or cerebrovascular accident (CVA): A stroke can cause sudden hearing loss, especially if it occurs in the brainstem or temporal lobe. Prompt recognition and treatment are crucial to prevent further brain damage.
- Multiple sclerosis: An autoimmune disease that can cause hearing loss, vision problems, and other neurological symptoms. Early diagnosis and treatment can help manage the condition.
- Meningitis: An infection of the membranes surrounding the brain and spinal cord, which can cause hearing loss, fever, and headache. Prompt treatment with antibiotics is essential to prevent serious complications.
- Rare Diagnoses
- Lyme disease: A bacterial infection that can cause hearing loss, especially if it affects the inner ear or nerve pathways.
- Syphilis: A sexually transmitted infection that can cause hearing loss, especially in its late stages.
- Cogan syndrome: A rare autoimmune disorder that can cause hearing loss, vision problems, and other systemic symptoms.
- Sarcoidosis: An autoimmune disease that can cause hearing loss, especially if it affects the inner ear or nerve pathways.