Mumbai doctors shed light on Alka Yagnik’s diagnosis of sensorineural nerve hearing loss. What is it?

Renowned Indian playback singer Alka Yagnik gave a major health update to fans when she revealed about suffering from a rare sensory neural hearing loss due to a viral attack after travelling by flight. With more celebrities like Yagnik talk about their health, there is a lot more awareness about different conditions now more than ever before and it is no different with her recent health update. So, what really is Sensorineural nerve hearing loss?

"Sensorineural nerve hearing loss or SNHL is a rare type of hearing loss that happens when the tiny hair cells in the inner ear or the nerve that connects the ear to the brain get damaged, according to Dr. Sheetal Radia, Consultant Otorhinolaryngology and Head & Neck Oncosurgery, Wockhardt Hospitals in Mira Road. "It is an emergency in ENT practice. It is characterised by average hearing loss of more than 30 decibels in 3 contiguous frequencies within 72 hours. Incidence: from 10 to 70 cases per year for a population of 100,000," adds Dr. Sanjiv Badhwar, consultant and head, ENT Services at Kokilaben Dhirubhai Ambani Hospital Mumbai.

In her Instagram post, the singer known for many Bollywood hits including ‘Ek Do Teen' from Tezaab (1988), said, "To all my fans, friends, followers and well wishers. A few weeks ago, as I walked out of a flight, I suddenly felt I was not able to hear anything. Having mustered some courage in the weeks following the episode, I want to break my silence now for all my friends and well wishers who have been asking me why I'm missing in action."

"It has been diagnosed by my docs as a rare sensory neural nerve hearing loss, due to a viral attack. This sudden, major setback has caught me completely unawares. As I attempt to come to terms with it please keep me in your prayers. For my fans and young colleagues, I would add a word of caution regarding exposure to very loud music and headphones. One day, I wish to share the health perils of my professional life. With all your love and support I am hoping to recalibrate my life and come back to you soon. Your support and understanding will mean the world to me in this critical hour," she added.

Mid-day.com spoke to Dr Radia and Dr Badhwar to know more about the condition and how severe it is. They not only explain the causes but also stress on the need to take care of loud sounds.

What is rare sensory neural nerve hearing loss and what are the different kinds of such conditions?
Radia: Sensorineural nerve hearing loss (SNHL) is a rare type of hearing loss that happens when the tiny hair cells in the inner ear or the nerve that connects the ear to the brain get damaged. SNHL is one of the primary causes of hearing loss in adults. It can range from mild to completely losing the capabilities of hearing depending on the severity of the damage.

There are three types of SNHL, classified as bilateral sensorineural hearing loss, unilateral sensorineural hearing loss, and asymmetrical sensorineural hearing loss. Bilateral sensorineural hearing loss in simple words means loss of hearing in both ears due to genetics, prolonged exposure to loud noise, and health problems like measles. It can gradually develop over time, and suddenly in some rare cases.

Unilateral sensorineural hearing loss is a type of hearing loss that only affects one ear due to reasons like tumors, Meniere's disease, mumps, infection, and persistent loud noise in one ear. Asymmetrical sensorineural hearing loss means the impact of hearing loss is different in each ear but one side is worse than the other depending on the damage caused.

What are the different ways in which it is caused?
Radia: SNHL can be caused by multiple reasons such as Congenital, sudden, and acquired. Acquired sensorineural nerve hearing loss can occur due to several factors such as exposure to loud noise, change in pressure during scuba diving, or traveling in a plane, resulting in hearing loss and damage to delicate parts of the ear. It simply means that hearing loss usually develops after birth.

Badhwar: The causes of the condition are viral infection, Covid, vascular occlusion, autoimmune conditions, barotrauma, intense noise exposure, injuries, ototoxic medication and tumours. The investigations usually include a complete ENT examination, audiological examination, audiometry, MRI, and blood tests if indicated.

What is a viral attack and what role does it play in causing it?
Radia: A viral attack in general means an infection caused by a certain virus. In Sensorineural nerve hearing loss, viruses like mumps, measles, rubella, and cytomegalovirus can severely infect the auditory nerve or the inner ear. This further leads to experiencing inflammation and discomfort and also increases the risk of permanent hearing loss.

Who gets most affected by it? Does it have a particular age group?
Radia: Sensory hearing loss can happen to anyone from all age groups. However, the cause of SNHL might differ in each age group. Some children are born with hearing loss due to genetics or infections; this is also called Congenital hearing loss. Adults develop hearing loss mostly due to prolonged exposure to loud noises at the workplace, or public transportation which can damage their inner ear leading to permanent hearing loss. As people get older, their capabilities of hearing decrease over time; this is also known as age-related hearing loss.

Badhwar: While a good prognisis can let it have a short history, as well as improvement in the first two weeks, and the absence of vertigo, a poor prognosis leads to late presentation, usually above the age of 60 years, and has associated vertigo and profound hearing loss (more than 90 decibels).

Alka Yagnik also highlighted about exposure to loud musicand headphones. How does their usage affect the ears in such cases?

Radia: Using headphones or earphones for prolonged periods that too at full volume can affect your ears. Headphones and earphones can send direct sound to your ear canal, making it more harmful compared to sounds in a normal environment. Once the hair cells that are responsible for transmitting sound signals get damaged, they do not regenerate or heal on their own, further leading to permanent hearing loss.

Can people prevent hearing loss? If yes, please suggest tips.

Radia: Avoiding loud noises or environments such as concerts, construction sites, or loud machinery will prevent hearing loss. If you can't avoid these places, then always remember to use earplugs to ensure your safety. Limit the use of headphones or the maximum volume as this can significantly hamper your hearing capabilities. Get your hearing checked if you notice certain difficulties in hearing or work in loud environments.

Why should people take sensory neural nerve hearing loss seriously?
Radia: Sensorineural nerve hearing loss or hearing loss in general, should be taken seriously and adversely impact an individual's daily life. Struggling to hear or completely losing the capability of hearing can take a toll on mental health causing stress and anxiety. One might always feel left out or worry about missing important sounds increasing the risk of isolation and depression. Early detection can help reduce the chances of getting SNHL and lead to positive outcomes.

Does the condition present permanent hearing loss?
Radia: SNHL is generally permanent and once the hair cells present in the inner ears are damaged or lost, they can't be treated. These hair cells do not heal or regenerate independently compared to other tissues in the body. It can also permanently cause damage to the Auditory Nerve which is responsible for transmitting sound signals from the cochlea (auditory organ) to the brain. Severe damage to this nerve can result in infections, diseases, or trauma.

What is the treatment method?
Radia: After diagnosing the SNHL by audiometry report and detecting hearing loss, doctors further suggest treatment options depending on the damage caused. If a person is having a sudden SNHL, doctors prescribe systemic steroids, and also steroid injections behind the eardrum which help in reversing the hearing loss.

Badhwar: The patient is given intensive treatment for 10 days. This includes steroids, antivirals, vasodilators, hyperbaric oxygen treatment. This is supported by 3 steroid injections given in the ear at weekly intervals. These patients are monitored carefully with serial hearing assessment. About 30-40 per cent of patients show recovery which may be complete or partial.

These patients are carefully followed up and those who have moderate hearing loss are offered hearing aids. Those patients who have persistent severe to profound hearing loss which persists for 3 to 6 months after the onset of this condition are suitable candidates for a Cochlear Implant which can restore their hearing and give them a good quality of life. Therefore, people who do suffer from this condition should not despair because today we have excellent solutions to mitigate this ailment.

Since she experienced it after getting off a flight, what should people keep in mind while travelling by flight for their ears?

Radia: When flying there's a sudden change in air pressure which can highly impact an individual's ears. In rare cases, this air pressure can further lead to discomfort, temporary hearing loss, and even sensorineural nerve hearing loss. Changes in pressure between the outer ear and the middle ear mainly cause it. Chewing gum or snacking on candy promotes swallowing. Swallowing can help open the Eustachian tube, which is responsible for equalising air pressure on both sides of the eardrum. Start chewing on candy just before take-off and landing to prevent your ears from getting blocked.

Lastly, how can people take care of their ears to avoid sensory neural nerve hearing loss?

Radia: It is important to take necessary precautions to reduce the risk of developing SNHL. This can be achieved by doing needful safety measurements such as wearing ear plugs or noise cancellation headphones in loud environments such as concerts or parties, limiting the usage of earphones or earpods for prolonged periods, lowering the volume of TV and music systems, and lastly by getting regular hearing checkups. People working in factories where the noise is more than 85 decibels should use ear plugs, and earmuffs to protect their ears from noise pollution. Regular hearing screening also known as audiological evaluations is crucial in monitoring and maintaining healthy hearing in individuals.