Differential Diagnosis for Sudden Hearing Loss
- Single most likely diagnosis:
- Sudden Sensorineural Hearing Loss (SSNHL): Given the patient's history of sudden complete deafness in one ear and now experiencing similar symptoms in the other ear, SSNHL is a strong consideration. The sudden onset, feeling of ear fullness before the loss, and the specific mention of difficulty hearing low-frequency sounds are consistent with this diagnosis.
- Other Likely diagnoses:
- Meniere's Disease: The patient's history of vertigo, vomiting, and the progression of hearing loss could suggest Meniere's disease, especially if the episodes of vertigo are recurrent and associated with tinnitus and aural fullness.
- Acoustic Neuroma: Although less likely given the sudden onset, an acoustic neuroma could cause unilateral hearing loss and vertigo. However, the sudden loss and specific symptoms might not fully align with the typical presentation of an acoustic neuroma.
- Do Not Miss diagnoses:
- Stroke or Cerebrovascular Accident: It's crucial to rule out a stroke, especially given the sudden onset of symptoms. While the presentation might not be typical for a stroke, the sudden loss of hearing, especially if accompanied by other neurological deficits, warrants immediate investigation.
- Multiple Sclerosis: This condition can cause a wide range of neurological symptoms, including hearing loss and vertigo. Although less common, it's a diagnosis that should not be missed due to its significant implications for management and prognosis.
- Rare diagnoses:
- Cogan Syndrome: A rare disorder that can cause recurrent corneal inflammation and vestibular-auditory symptoms, including hearing loss and vertigo. It's less likely but should be considered in the differential due to its unique combination of symptoms.
- Autoimmune Inner Ear Disease: This condition involves the immune system attacking the inner ear, leading to hearing loss, vertigo, and tinnitus. It's a rare cause of sudden hearing loss but could be considered, especially if other diagnoses are ruled out and there's evidence of an autoimmune process.