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A sudden change in hearing can be frightening, especially when it affects one ear without an obvious reason. One moment a phone call sounds normal; the next, it may seem muffled, distant or markedly quieter. It is natural to hope the change will settle by the next morning.
However, sudden hearing loss should not be managed by waiting to see whether it improves. While causes such as earwax or middle-ear fluid are possible, a sudden drop in hearing may also represent sudden sensorineural hearing loss, a time-sensitive condition affecting the inner ear.
Prompt assessment helps distinguish between different causes and allows appropriate treatment to be considered without unnecessary delay. The treatment window is not defined by one exact deadline, but timing can influence the options available.
This guide explains nine warning signs to recognise, when emergency-department care may be appropriate, what assessment in Singapore may involve and what information to prepare during the first 24 hours. The aim is to help you respond calmly and appropriately if sudden hearing loss happens to you or someone close to you.
A sudden drop in hearing in one ear is not something to sleep on. The sooner it is checked, the stronger the odds.
Why a Sudden Hearing Change Is Urgent
A sudden loss of hearing, usually in one ear, is a time-sensitive condition in ear, nose and throat medicine. When the hearing loss arises from the inner ear or hearing nerve, it is called sudden sensorineural hearing loss, or SSNHL. It is commonly defined as a drop of at least 30 decibels across three consecutive frequencies developing within 72 hours.
SSNHL is uncommon. A frequently cited estimate is 5–20 cases per 100,000 people each year. Singapore General Hospital has noted that, when applied to a population of about six million, this would equate to approximately 300–1,200 cases annually. This is an estimate rather than a measured local incidence. In most cases, no specific cause is identified, and the condition is described as idiopathic.
people each year
Singapore (SGH estimate)
72 hours defines SSNHL
Prompt assessment is important because SSNHL may lead to lasting hearing loss, although recovery varies and some people improve without treatment. Earlier assessment allows hearing tests to be arranged and time-sensitive treatment options to be considered. Current American Academy of Otolaryngology guidance states that corticosteroids may be offered within two weeks of symptom onset and recommends obtaining an audiogram as soon as possible.
Because the cause cannot be determined from symptoms alone, a sudden unexplained hearing change should be assessed promptly rather than monitored at home for several days.
Sources: Singapore General Hospital; AAO-HNS Clinical Practice Guideline (2019).
The 9 Warning Signs
The following nine signs are the most important reasons to arrange same-day ENT assessment or, for some, to go straight to A&E.
| # | Warning Sign | Suggested Action |
|---|---|---|
| 1 | A sudden drop in hearing in one ear | Urgent — within 24h |
| 2 | A blocked or full feeling without pain | Urgent — within 24h |
| 3 | New tinnitus with a change in hearing | Urgent — within 24h |
| 4 | Spinning dizziness (vertigo) with hearing symptoms | Urgent / A&E if severe |
| 5 | Distorted or strange-sounding hearing | Urgent — within 24h |
| 6 | New sensitivity to ordinary sounds | Urgent — within 24h |
| 7 | Facial weakness or numbness with hearing loss | A&E immediately |
| 8 | A severe headache with hearing loss | A&E immediately |
| 9 | Fluctuating hearing that suddenly worsens | Urgent — within 24h |
1. A Sudden Drop in Hearing in One Ear
What to do: Do not insert anything into the ear. Note when the change began and seek urgent medical assessment, ideally within 24 hours. Where timely ENT review is unavailable, attend an emergency department.
2. A Blocked or Full Feeling Without Pain
What to do: Note any change in hearing and any recent flying, diving or pressure exposure. Avoid forceful nose-blowing if the symptoms followed a pressure change, and seek urgent medical assessment, ideally within 24 hours. Attend A&E if the hearing loss is profound, timely ENT review is unavailable, or you also develop severe vertigo, difficulty walking or neurological symptoms.
3. New Ringing (Tinnitus) With a Change in Hearing
What to do: Note when the tinnitus and hearing change began, and seek urgent medical assessment, ideally within 24 hours. Do not rely on how mild or severe the hearing loss feels when deciding whether to have it checked.
4. Spinning Dizziness (Vertigo) With Hearing Symptoms
What to do: Sit or lie down to reduce the risk of falling and avoid driving. Seek urgent medical assessment. Go to A&E if the vertigo is severe, you cannot walk safely, or you develop facial weakness, slurred speech, double vision, limb weakness or a sudden severe headache.
5. Distorted or Strange-Sounding Hearing
What to do: Note when the change began and which sounds seem affected. If the distortion appeared suddenly or occurs with reduced hearing, tinnitus or ear fullness, seek urgent medical assessment, ideally within 24 hours.
6. New, Uncomfortable Sensitivity to Ordinary Sounds
What to do: Avoid genuinely loud noise, but do not block out ordinary sounds continuously unless advised by a clinician. Note which sounds trigger the discomfort. If the sensitivity began with sudden hearing loss, tinnitus or ear fullness, seek urgent medical assessment, ideally within 24 hours.
7. Facial Weakness or Numbness With Hearing Loss
What to do: Go to A&E immediately, especially if the face appears uneven or you also have slurred speech, double vision, limb weakness or difficulty walking. Do not delay assessment to perform repeated self-checks. Imaging may be arranged depending on the findings.
8. A Severe Headache With Hearing Loss
What to do: Go to A&E immediately. Do not delay care, but note when the headache began and whether you also have fever, neck stiffness, vomiting, vision changes, facial weakness, slurred speech or limb weakness.
9. Hearing That Has Been Fluctuating and Suddenly Worsens
What to do: Note when the fluctuations began and whether they occur with tinnitus, ear fullness or vertigo. Seek urgent medical assessment, ideally within 24 hours.
Sudden (Sensorineural) Versus Conductive Hearing Loss
There are two broad types of hearing loss, and sometimes both occur together. For a broader overview of the causes and types, see our hearing loss overview.
Sudden Sensorineural (SSNHL)
A time-sensitive inner-ear condition needing urgent assessment. Typical features: a sudden drop in hearing in one ear, new tinnitus and, in some cases, vertigo. Early corticosteroids may be considered, but recovery cannot be predicted.
Acute Conductive
Sound is reduced before it reaches the inner ear. Possible causes include impacted earwax, middle-ear fluid or a perforated eardrum. Does not usually require the time-sensitive corticosteroid treatment, but prompt assessment still matters.
Mixed
Conductive and sensorineural loss occur together. The important point is to identify any sensorineural component promptly, as it may require time-sensitive assessment and can result in lasting hearing loss.
Quick Triage: A&E Now, or Same-Day ENT?
Match your situation to the guidance below. When symptoms overlap, choose the more urgent option.
Call 995 if stroke, serious injury or another life-threatening emergency is suspected, or if the person cannot travel safely.
If timely ENT assessment is unavailable, attend A&E.
- Where possible, arrange urgent assessment within 24 hours.
- Dr Gan Eng Cern's ENT Clinic is located at Mount Elizabeth Novena Hospital. Appointments may be arranged at +65 6253 7296 or via WhatsApp at +65 9058 2480.
- A referral is generally not required for a private consultation.
Sudden Change in Your Hearing?
What to Expect at Your Appointment
An ENT assessment focuses on confirming the type of hearing loss and finding any cause that changes how you are treated. Your ENT may carry out the following.
| Assessment | What It Involves |
|---|---|
| History & ear examination | When the loss began, which ear is affected and what else you have noticed. The ear is examined, and simple tuning-fork tests can give an early clue as to whether the loss is sensorineural or conductive. |
| Audiometry | A pure-tone and speech hearing test measures and confirms the loss. SSNHL is confirmed when there is a drop of at least 30 decibels across three neighbouring frequencies. |
| Tympanometry | Checks how the middle ear is working and helps tell a conductive cause from a sensorineural one. |
| Otoacoustic emissions | In some cases, this objective test of the inner-ear hair cells is used to support the diagnosis. |
| MRI scan | If a cause behind the inner ear is suspected, such as a benign growth on the hearing nerve, an MRI with contrast may be arranged. This should not hold up the start of treatment. |
| CT scan | Reserved for specific situations, such as a suspected fracture, and is not part of the routine first assessment. |
| Blood tests | Not routine, but selected tests may be done when the picture is unusual, for example with both ears affected or repeated episodes. |
Your First 24 Hours: A Simple Action Plan
A calm, organised response can help you communicate the important details clearly. Three steps cover most of what matters.
Write It Down
When the change began, which ear, and associated symptoms — plus any recent illness, flying, diving, noise, injury or new medication.
Get Assessed
See an ENT the same day where possible; otherwise go to A&E. Bring your NRIC/passport, medicines and allergies, previous hearing tests and insurance details.
Follow the Plan
If corticosteroids are prescribed, take them exactly as directed and mention diabetes or other conditions. Attend follow-up and repeat hearing tests.
Step 1: Write It Down
Note when you first noticed the hearing change, which ear is affected and any associated symptoms, such as tinnitus, ear fullness, vertigo or facial weakness. Include any recent illness, ear infection, flying, diving, loud-noise exposure, head injury or new medication.
Step 2: Get Assessed
See an ENT specialist the same day where possible. If you cannot, go to A&E. A clear sentence helps at triage, for example: "I have had sudden hearing loss in one ear since [time], and I understand it needs urgent assessment." Bring your NRIC or passport, a list of your medicines and allergies, any previous hearing tests, and your insurance details.
Step 3: Follow the Recommended Treatment Plan
If SSNHL is diagnosed and corticosteroids are prescribed, take them exactly as directed. Tell the prescribing doctor about diabetes and any other medical conditions or medications that may affect whether steroids are suitable. Attend the recommended follow-up appointments and repeat hearing tests.
- Do not insert cotton buds, ear candles or other objects into the ear.
- Do not use unprescribed ear drops or home remedies.
- Do not take corticosteroids without medical supervision.
- Avoid unnecessary exposure to loud noise.
- Do not wait several days to see whether the hearing returns on its own.
Need Medical Advice from an ENT Specialist?
No referral is required. Whether you are seeking a diagnosis, treatment advice or a second opinion, Dr Gan provides specialist assessment and personalised treatment planning.
Contact UsTreatment Options and What to Expect
Treatment aims to support hearing recovery while balancing the possible benefits and risks of each option. Recovery varies between individuals, and no treatment can guarantee that hearing will return.
Oral Corticosteroids
Commonly considered as an initial treatment for SSNHL. Guidance states they may be offered within two weeks of symptom onset. Your ENT will weigh potential benefits against possible side effects.
Intratympanic Injections
Corticosteroid delivered through the eardrum into the middle ear. May be considered when oral steroids are unsuitable, or as salvage treatment for incomplete recovery two to six weeks after onset.
Hyperbaric Oxygen
Offered by some centres together with corticosteroids — within two weeks as an initial option or within one month as salvage. Availability, benefits, risks, costs and practical demands should be considered individually.
Treatments that are not routinely advised. Antiviral medicines, thrombolytics, vasodilators and vasoactive substances are not recommended for routine treatment of idiopathic SSNHL because there is insufficient evidence of clear benefit.
What Are My Chances of Recovery?
Recovery varies, and it is not possible to predict the outcome with certainty at the first assessment. Studies suggest that some people recover part or all of their hearing without treatment, but reported rates vary because different studies use different definitions of recovery.
Factors that may influence the outlook include age, the severity and pattern of hearing loss, whether vertigo is present and how soon assessment and treatment begin. Prompt assessment is important because it allows the hearing loss to be measured, possible causes to be considered and time-sensitive treatment options to be discussed.
Follow-Up and Recovery
Treatment is only the first phase. Planned follow-up supports your hearing and helps manage any symptoms that linger.
- Early repeat hearing tests show how you are responding, with further audiograms over the following weeks to guide any change in approach.
- A review at around three months often gives a clearer picture of the final result, with longer-term checks on the other ear.
- Persistent tinnitus or sound sensitivity can be helped by approaches such as sound therapy, tinnitus retraining therapy, or counselling.
- If balance symptoms continue, vestibular rehabilitation can help.
- If a significant hearing loss remains, your ENT can discuss rehabilitation options such as hearing aids, bone-conduction devices, or assessment for a cochlear implant.
Children, Older Adults, and People Whose Work Depends on Hearing
Children
Young children may not describe a hearing change clearly. Signs may include responding less consistently to sound, turning one ear towards voices, or seeming unusually inattentive. Any sudden or unexplained change should be assessed promptly.
Older Adults & Other Conditions
Age alone does not determine treatment, but existing conditions and medicines may affect which options suit. People with diabetes may need closer monitoring if systemic corticosteroids are prescribed. Tell the doctor about all conditions, medications and allergies.
Work Depends on Hearing
Sudden hearing loss needs the same urgent assessment regardless of occupation. For musicians, teachers, pilots and those in noisy or safety-sensitive roles, remaining difficulty may affect communication, safety or duties — discussed during follow-up and rehabilitation.
Frequently Asked Questions: Sudden Hearing Loss in Singapore
The following questions reflect what patients in Singapore commonly ask about a sudden change in hearing. For more questions across ear, nose and throat topics, see our ENT FAQ hub. For advice specific to your situation, consult an ENT specialist directly.
- Treat sudden hearing loss as urgent. Seek assessment as soon as possible, ideally within 24 hours.
- Know the common signs. These include one-sided hearing loss, tinnitus, ear fullness, distorted hearing or vertigo.
- Go to A&E for red flags. Seek emergency care for facial weakness, slurred speech, double vision, severe headache or difficulty walking.
- Get a hearing test early. An audiogram helps confirm the type and degree of hearing loss.
- Treatment may be time-sensitive. Corticosteroids may be considered within two weeks, but recovery varies.
- Do not self-treat. Avoid cotton buds, ear candles, unprescribed drops and steroids without medical supervision.
- Bring a clear timeline. Note when symptoms began and any related illness, noise exposure, injury or medication changes.
About the Reviewer: Dr Gan Eng Cern
Dr Gan Eng Cern is a fellowship-trained ENT specialist and rhinologist at Mount Elizabeth Novena Hospital, Singapore. He completed his subspecialty fellowship at St Paul's Sinus Centre, University of British Columbia, Vancouver, funded by the HMDP Award from the Ministry of Health, Singapore, and has served as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, NUS.
This guide was reviewed for accuracy and clarity against current clinical guidelines. As Dr Gan's subspecialty focus is rhinology, the hearing-specific clinical content here is kept general and guideline-based.
| Detail | Information |
|---|---|
| Subspecialty | Rhinology (nose & sinus) · Endoscopic skull base surgery |
| Location | 38 Irrawaddy Road, #08-45, Mount Elizabeth Novena Hospital, Singapore 329563 |
| Clinic Hours | Mon–Fri: 9:00am – 5:00pm · Sat: 8:30am – 12:00pm |
| Languages | English, Mandarin (limited), Malay, Hokkien |
| Qualifications | MBBS (UNSW), MRCS (Edinburgh), MMed in ENT (NUS), FAMS |
| Referral Required? | No — direct consultation available |
For Dr Gan's full profile — qualifications, research, awards, teaching appointments, and publications — visit About Dr Gan Eng Cern.
Conclusion
A sudden loss of hearing in one ear requires urgent medical assessment. The pattern may include a rapid drop in hearing on one side, often with new tinnitus, a blocked feeling or dizziness.
Where possible, arrange assessment within 24 hours. Go to A&E immediately if the hearing loss occurs with facial weakness, slurred speech, double vision, a sudden severe headache or difficulty walking safely. A hearing test helps confirm the type and degree of hearing loss so that time-sensitive treatment options can be considered.
Do not wait several days to see whether the hearing returns on its own. Prompt assessment is important because recovery varies and spontaneous improvement cannot be assumed.
Consult Dr Gan Eng Cern
ENT Specialist & Rhinologist · Mount Elizabeth Novena Hospital
Contact the clinic
Call +65 6253 7296 during clinic hours, or WhatsApp +65 9058 2480 at any time. No referral letter is required.
Prepare for the visit
Bring your NRIC or passport, any previous hearing tests or scans, a list of your medicines, and your insurance details.
Visit the clinic
38 Irrawaddy Road, #08-45, Mount Elizabeth Novena Hospital, Singapore 329563. Directly connected to Novena MRT (NS20). Clinic staff can assist with insurance pre-authorisation, Letters of Guarantee, and Medisave eligibility before your visit.
Medical Disclaimer: The information in this article is intended for general educational purposes and does not constitute medical advice. It is not a substitute for a professional consultation, diagnosis, or treatment plan from a qualified medical practitioner. Circumstances vary from person to person. Always consult a registered medical practitioner for advice specific to your situation. If you think you are experiencing sudden hearing loss, seek medical care promptly. This information has been prepared in accordance with the Healthcare Services (Advertisement) Regulations 2021 and Ministry of Health Singapore guidelines for healthcare information. In an emergency, go to the nearest A&E department or call 995.
Last reviewed: June 2026 · © Dr Gan Eng Cern ENT Clinic
Sources:
1. American Academy of Otolaryngology, Head and Neck Surgery. Clinical Practice Guideline: Sudden Hearing Loss (Update), 2019. aao-hnsfjournals.onlinelibrary.wiley.com
2. Singapore General Hospital. Managing Sudden Sensorineural Hearing Loss in Primary Care. sgh.com.sg
3. Frontiers in Neurology. Time from onset of SSNHL to treatment, 2023. frontiersin.org
4. Defense Health Agency. SSNHL Standard Procedure (definition and diagnostic criteria).
