”Dr. Lu, the phone call from the family of a certain patient, the patient seems to be in trouble”, just after the room check, the nurse suddenly said to me, I was shocked: the patient was admitted to the hospital a few days ago because of sudden deafness, last night was fine, took leave to go back, how suddenly something happened! I rushed to pick up the phone. “Dr. Lu, hello, I am the family of a certain person, he suddenly felt a side of the body weakness last night, slurred speech, we rushed to the nearby hospital to see, did a CT, this side of the doctor said it is a cerebral infarction, I hope you can communicate the drugs used in the past few days with the doctor here, so that the next step in treatment. “Ah! How can this be, we’ve been on anticoagulants for the past few days and we still have a cerebral infarction!” This is a case I encountered some time ago. This patient has a disease called sudden deafness, which refers to the sudden onset of sensorineural deafness within 72 hours, possibly combined with tinnitus, vertigo, and ear congestion. The incidence of this disease is about 5 to 20/100,000 per year worldwide, and it is gradually increasing. Many patients do not feel any discomfort before the onset of the disease, but wake up and find that they cannot hear in one ear, which makes them feel like they are falling down. Some patients have hearing loss in the low-frequency region, which is not in the frequency range of our daily speech, so they do not feel the hearing loss very clearly, and may go to the doctor because of the symptoms of tinnitus and vertigo. The cause of sudden deafness is still a worldwide problem, and there is no definite answer. Some scholars believe that it is caused by a viral infection that damages the inner ear (the nerve that senses sound in humans), while others believe that it is caused by a build-up of lymphatic fluid (commonly known as “ear water”) in the inner ear that causes lesions in the nerve cells that sense sound. It is generally accepted that impaired vascular circulation in the inner ear is the most common cause. The blood supply to the inner ear is unique in that it is supplied by only one small artery (medically known as the labyrinthine artery), unlike other organs where there are multiple arteries and other vessels can supply blood when one is blocked. Although the inner ear is small in size, it accounts for about 14% of the blood supply to the arteries of the body. Once the blood supply to the brain is insufficient, hearing is significantly less important than other more important life centers such as heartbeat and respiration. In some sense, sudden deafness is a normal defense response of the body. Recent studies have found that patients with a history of sudden deafness are 6 times more likely to have a cerebrovascular accident, which explains the condition of the patient at the beginning of the article, whose symptoms improved significantly with neurological treatment, and who could have had a more serious cerebrovascular accident if he had not been seen when the deafness first occurred. When patients with sudden deafness are informed of their condition, they usually ask, “Is this treatable?” I usually explain to the patient like this: this disease is not an ordinary trauma that can basically grow back with a few stitches, it is a disease of nerve damage, and nerve cells are different from ordinary cells, once they die they cannot be regenerated, just like brain hemorrhage or brain infarction, sometimes even after timely and accurate treatment there are still sequelae, so there is no way to “packaged cure”. The success rate of treatment is currently considered to be related to the type of hearing loss. Low frequency hearing loss is treated best and can have an efficiency rate of 80% or more, while severe total deafness (loss of all frequencies) and hearing loss in high frequency areas are treated less effectively. The timing of treatment is the same as stroke, the earlier the treatment, the better the effect; there are many drugs for the treatment, the one recognized as effective worldwide is hormone, which can be used orally and intravenously, and the physician will add drugs for nerve nutrition, thrombus dissolution, blood vessel expansion and anticoagulation according to his experience and the patient’s condition. Strictly speaking, sudden deafness is a milder type of cerebrovascular accident that may be partly a precursor to a serious cerebrovascular accident. It should draw sufficient awareness and attention from physicians and patients to not let a stroke inside the ear develop into a stroke, to nip the disease in the bud, and to reduce the damage to the patient’s health from vascular accidents.