Unexplained sudden sensorineural hearing loss in adolescent: a warning for functional hearing loss

Functional hearing loss refers to a type of hearing impairment that occurs without any identifiable organic damage to the auditory system. Most of the existing literature focuses on adults, with less attention given to the pediatric population. However, there is an increasing number of psychosomatic issues among children and adolescent, and dysthymic hearing loss in adolescent is not uncommon in clinical practice. In this article, we presented 21 cases of functional hearing loss in adolescent treated in our center over the last 3 years. We summarized our experience in diagnosing and treating these cases to reduce diagnostic errors and improve the patients' quality of life. The study identifies academic stress (19.04%), Violence by parents or teachers (14.29%), interpersonal conflicts (4.76%), and mental health issues such as anxiety and depression (23.81%) as significant factors contributing to the development of functional hearing loss. Additionally, 47.62% of patients reported an unknown reason for their deafness. We found that 66.67% of dysthymic hearing loss was monaural, making it difficult to differentiate it from sudden deafness. Repeated audiometric evaluations often showed fluctuating or non-reproducible hearing thresholds. During a mean follow-up of 15.23 months, 55% of patients received psychological intervention. Overall prognosis was favorable, with 95% achieving complete recovery. Functional hearing loss should be suspected in sudden-onset cases, especially when psychological or behavioral abnormalities are present. Early objective auditory assessment is essential in unilateral hearing loss with inconsistent audiometric findings. Accurate diagnosis and treatment are crucial for the prognosis of patients. For childhood dysthymic disorders, timely and effective psychotherapy often leads to a better prognosis, which requires a well-established multidisciplinary cooperation mechanism.