Differential Diagnosis for Abrupt Onset Hearing Loss and Tinnitus
Single Most Likely Diagnosis
- Idiopathic Sudden Sensorineural Hearing Loss (SSNHL): This condition is characterized by a sudden loss of hearing, often accompanied by tinnitus, and is usually unilateral. It is a diagnosis of exclusion, and the exact cause is often unknown. The abrupt onset and presence of tinnitus make it the most likely diagnosis.
Other Likely Diagnoses
- Middle Ear Infection: An infection in the middle ear can cause sudden hearing loss and tinnitus due to the accumulation of fluid or the presence of an infection. The symptoms can be similar to SSNHL but are usually accompanied by other signs of infection such as fever or ear pain.
- Meniere's Disease: This inner ear disorder can cause episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. While the hearing loss in Meniere's disease is typically fluctuating, some patients may experience sudden drops in hearing.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain can cause hearing loss and tinnitus, usually on one side. The onset can be sudden, but more often it is gradual.
Do Not Miss Diagnoses
- Stroke or Cerebrovascular Accident (CVA): A stroke affecting the auditory pathways in the brain can cause sudden hearing loss. It is crucial to rule out a stroke, especially if there are other neurological symptoms.
- Multiple Sclerosis: This autoimmune disease can cause a wide range of neurological symptoms, including sudden hearing loss and tinnitus, due to demyelination in the central nervous system.
- Cerebellopontine Angle (CPA) Tumors: Tumors in this region, aside from acoustic neuromas, can also cause sudden hearing loss and tinnitus by compressing the auditory nerve.
Rare Diagnoses
- Autoimmune Inner Ear Disease: A rare condition where the body's immune system attacks the inner ear, leading to sudden hearing loss and tinnitus.
- Syphilis: In its late stages, syphilis can cause a variety of neurological problems, including sudden hearing loss.
- Cogan Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including sudden hearing loss and tinnitus.
- Sjögren's Syndrome: An autoimmune disorder that can affect various parts of the body, including the ears, leading to sudden hearing loss and tinnitus, though this is less common.