Differential Diagnosis for Loss of Hearing in One Ear
Single Most Likely Diagnosis
- Unilateral Sensorineural Hearing Loss: This is often due to age-related hearing loss, noise exposure, or viral infections affecting the inner ear. It's the most common cause of single-sided hearing loss due to its prevalence and the broad range of potential causes.
Other Likely Diagnoses
- Middle Ear Infection (Otitis Media): Bacterial or viral infections can cause fluid buildup or inflammation in the middle ear, leading to hearing loss in one ear. This condition is common and can be acute or chronic.
- Earwax Impaction: A buildup of earwax can block the ear canal, causing hearing loss. This is a common and easily treatable condition.
- Perforated Eardrum: A tear or hole in the eardrum can lead to hearing loss, often accompanied by other symptoms like pain or discharge.
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, tinnitus, and hearing loss, which can initially present unilaterally.
Do Not Miss Diagnoses
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause unilateral hearing loss, tinnitus, and balance problems. Early detection is crucial for effective treatment.
- Stroke or Cerebrovascular Accident: Although less common, a stroke affecting the brainstem or auditory pathways can result in sudden unilateral hearing loss. Prompt recognition and treatment are critical.
- Multiple Sclerosis: An autoimmune disease that can affect the central nervous system, including the auditory pathways, leading to hearing loss among other neurological symptoms.
Rare Diagnoses
- Ototoxicity: Certain medications or chemicals can damage the inner ear, leading to hearing loss. This is less common but important to consider, especially in patients with exposure to known ototoxic substances.
- Autoimmune Inner Ear Disease: A rare condition where the body's immune system attacks the inner ear, causing hearing loss, which can be unilateral or bilateral.
- Cogan Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including hearing loss.
- Syphilis: A bacterial infection that can cause hearing loss in its late stages, among many other systemic symptoms.