acute hearing loss and tinnitus in left ear

[satscout]

I am a medical transcriptionist.  The weekend after Thanksgiving, I reconnected with a friend of mine who works in digital audio and radio production.  He was complaining of acute reduction in the hearing of his left ear, tinnitus, and headaches.  He presented to an ENT, who sent him for an MRI with attention to the internal auditory canal and inner ear, which returned normal.  They tried him on steroids, which did nothing to help his ear but had the side effects of weight gain and constipation.  He was put on pain medicine for the headaches.  A couple of days ago, he called their office again, pretty much upset and demanding results.  His loss has progressed to complete loss of hearing in the left ear and partial loss of hearing in the right ear, and it's affecting his work.  The nurse to whom he spoke at the ENT's office said it was likely viral and called in a prescription for Valtrex as well as a course of prednisone.  He was upset about the Valtrex until I explained that herpes viruses were a family of viruses...  He has also told me he does not intend to take the prednisone, as the earlier course of steroids didn't help and he didn't tolerate the side effects well.  He is otherwise healthy and watches his diet, works out daily, etc.  The only other symptom he has reported to me is a single episode of drenching night sweats two nights ago that left him very worried - he fell asleep and slept far longer than he normally does, and woke up soaked through in sweat.  I am going to actually see him tomorrow morning and look at his ear for myself (I'm way out of practice though;  I was a medical student until my own health issues forced me to leave school, so I haven't done a formal physical exam in about 14 years).  Has anyone experienced sudden progressive loss of hearing like this?  What kind of diagnostic questions are appropriate to ask?  What kind of ideas should we be pursuing here?

[satscout]

This is exactly the kind of information I was fishing for.  I did not get to see him yesterday;  for whatever reason he failed to call me back, and I've been leaving voice messages on his cell with no response yet.  I can only hope he hasn't gotten acutely worse over the weekend.  He's not that old, only 34.  I wasn't expecting to see any physical findings, just wanted to look for myself and reassure him, mostly.  He is understandably quite upset, as his livelihood depends on his ears.  Thank you for answering.

[Wear/a/Jimmy]

a physical exam will probably yield ZERO information other than outwardly there is nothing wrong with him.

Here is a very good link:

http://www.utmb.edu/otoref/Grnds/SuddenHearingLoss-010613/SSNHL.htm

I would also call for OAE studies to be done. Depending on his age, they should be normal. If he is young, below 50, I would expect his OAEs to be present, if they are not, we can deduce that his hearing issues are based in the Cochlea. (Essentially confirming the MRI studies)

His doctor is following a fairly routine protocol for treatment in his case. I do know some doctors inject medication through the ear drum, and the research show that this procedure is more effective.  I have never seen or met any physicians that actually medicate in this way, but I have read about it.

Good luck to your friend.

(I know it does not help much, but at least we have cochlear implants theres days)