1.What is sudden deafness? Sudden deafness is a kind of sensorineural deafness that occurs suddenly within a few hours for unknown reasons, which can be accompanied by tinnitus and vertigo, without other cerebral nerve symptoms and signs except for the auditory nerve. The incidence of sudden deafness has been increasing in recent years, and compared with the previous situation of sudden deafness in middle-aged and elderly people, the number of students suffering from sudden deafness has increased significantly, and the incidence of sudden deafness is especially concentrated before midterm and high school exams. This is due to the fact that students are under high pressure and nervousness before examinations, and their hearing is prone to sudden deafness in a short period of time. In addition, due to social development and accelerated pace of life, white-collar workers in companies are also prone to sudden deafness due to mental tension and work pressure. The age of sudden deafness is gradually decreasing from 45 years old or above to 20 years old or even younger. Patients tend to have monaural onset, and bilateral sudden deafness is rare. There is no significant gender difference in the onset of the disease, no geographical or epidemiological clustering, and there are significant cyclical or seasonal characteristics. If left untreated, sudden deafness can cause lifelong deafness and should be taken seriously. 2. Etiology and pathogenesis of sudden deafness At present, the etiology and pathogenesis of sudden deafness are not fully understood, but can be broadly categorized into two main groups, i.e., well-defined etiology and presumed possible etiology. The possible etiologies of sudden deafness are mainly the following factors: 2.1 Viral infection is one of the main etiologies. Some patients have had viral infections caused by colds or other diseases before the onset of the disease, and it has been hypothesized that the inner ear is inflamed by viral infections that cause this condition. There are many studies on viral infections causing deafness, including measles virus, mumps virus, varicella zoster virus, syphilis, AIDS, typhoid fever and some cold viruses, etc. The population affected is mainly children and adolescents, but the proportion of adults is low, and the disease is mostly monaural. 2.2 Disorders of blood supply to the inner ear. The blood vessels supplying the inner ear are long and thin, and many reasons can affect the blood supply. In addition, in patients who are weak or bedridden for a long time, small blood clots are often formed in the blood vessels, which may be dislodged and blocked by the blood flow to the inner ear vessels. After ischemia in the inner ear, the hair cells that sense sound will degenerate or even become necrotic, and the auditory nerve that transmits signals will temporarily lose its function, thus causing sudden hearing loss. With timely treatment at this time, the changes in the hair cells and auditory nerve can return to normal and hearing will improve. 2.3 Autoimmune diseases. Some autoimmune patients, such as SLE, rheumatoid arthritis, and Cogon’s disease, also have sudden deafness in both ears, which may be caused by autoimmune antibodies destroying parts of the inner ear structure. 2.4 Trauma, tumors. Any factor that causes structural damage to the inner ear can lead to sudden deafness, such as exolymphatic fistula, temporal bone fracture, vagal oscillation, otologic surgery, and noise. These etiologies can be detected by medical history questioning and physical examination. Also, occupying lesions such as auditory neuroma, leukemia, bone marrow carcinoma, intracranial or internal auditory tract metastatic carcinoma can compress the nutrient vessels or innervated nerves of the inner ear and cause this disease. 2.5 Mental factors have been increasingly taken into account by most scholars. For example, chronic fatigue, physical and mental emaciation, psychological trauma, plant nerve dysfunction, and suboptimal immune system. This cause was previously limited to adults between the ages of 40 and 60, but there is now a trend toward a lower age group. In addition to the social competition factor, middle school and high school students are in the early stage of development and maturity, and the stress self-balancing ability of various systems and organs in the body has not yet been perfected physiological factors. Between 35 and 60 years old is the golden time of life, but at this time the social and family pressure is the greatest, but also the body organ function from the heyday to the stage of decline, at this time if the body and mind for a long time tension fatigue and not rest, coupled with uncontrolled alcohol and tobacco and sound stimulation, easy to lead to hearing and other functional disorders, once the development of the disease Once the disease develops, the psychological pressure is heavier than other age groups. 3, clinical manifestations 3.1 hearing loss. Suddenly occur in a few minutes or hours to reach the lowest point. It occurs mostly on one side, but rarely it can occur simultaneously or successively in both ears. The degree of deafness varies, most of them are moderate or severe sensorineural deafness, therefore, patients can mostly recall the exact time of hearing loss and the environment at that time. In cases of combined severe vertigo, the deafness is often overlooked and is only discovered after the vertigo symptoms have resolved. 3.2 Tinnitus. In some patients, tinnitus may occur intermittently in the hours before the onset of deafness and continue throughout the course of deafness. 3.3 Vertigo. This symptom accounts for 1/2 proportion of the disease and is accompanied by nausea and vomiting and a sense of fear, which mostly lasts for about a week and disappears. 3.4 Others. Some patients may have ear pain, ear swelling or ear pressure. 4.4 Factors affecting the treatment of sudden deafness 4.1 Treatment time: sudden deafness is an emergency in ear disease, and should be treated according to the requirements of rescue after the onset, and a few days later in moderate to severe patients may cause the consequences of prolonging the course of treatment and reducing the effectiveness. Generally, if you get effective treatment within one month, you will receive good therapeutic effect of hearing recovery. Those with hearing loss below 80 dB must get treatment within one week to have a hope of partial recovery. If the hearing loss is less than 80 decibels, the patient must be treated within one week to have the hope of partial recovery. 4.2 The patient’s mental and physical state and personality should be adjusted simultaneously with the treatment. 50-60% of patients with sudden deafness have physical and mental overwork, mental trauma and various problems of personality before the onset of the disease, which need to be appropriately relieved. We should make the patient understand that the treatment is just like the treatment of storm and flood, as long as the patient is properly guided, the disaster will disappear. 4.3 Improve the patient’s treatment environment: remove or reduce noise, high temperature, high-frequency electromagnetic fields, as well as tobacco and alcohol and other adverse stimuli, to ensure sleep and rest time. 4.4 Actively treat pre-existing hypertension, diabetes, cardiovascular disease and neurasthenia. 4.5 Any hot Chinese medicine that is a great tonic or anti-rheumatism should be used sparingly or not at this time to avoid aggravating the disease. 5. Prognosis The prognosis of sudden deafness can be broadly divided into three types of outcomes: 5.1 Patients with a small percentage of about 10% or less, who are young and have little mental stress, can recover within ten days without treatment. 5.2 About 60% of the patients need timely and appropriate treatment, and their hearing can be restored to near normal levels. 5.3 In about 30% of patients, it is difficult to recover hearing to normal level due to severe disease, stressful thinking or improper treatment. It is generally believed that the recovery of sudden deafness mostly starts 2 weeks after the onset of the disease, and the longer the duration of symptoms, the worse the prognosis, so timely consultation after the onset of the disease is one of the key factors to determine the degree of recovery of sudden deafness. 6. How to prevent The occurrence of this disease is partly related to viral infections and metabolic diseases, which need to be prevented from life, such as preventing colds and regulating diet. In adults, most of them are related to mental trauma and excessive physical and mental fatigue. Do not let mental states and emotions such as sadness and worry, suspicion and depression interfere with your life. It is important to resolve the stress, conflicts and stimuli related to oneself positively and maintain a healthy state of mind to prevent the “weakness of the body on the disease”. To prevent sudden deafness, we should also strengthen physical exercise to reduce the formation of blood clots, not to smoke excessively, not to drink alcohol, and to relax properly after a stressful day at work, not to have fun all night. In addition, heart disease and hypertension should be actively treated.