Sensorineural hearing loss

Sensorineural hearing loss

Sensorineural hearing loss results from a problem in the cochlea, the auditory nerve or, less commonly, the central auditory pathways. Age-related hearing loss is the most common form, but loss can also be congenital or acquired. This information supports and does not replace an individual ENT and audiology assessment.

How hearing is affected

Hair cells in the cochlea convert fluid movement into electrical signals that travel along the auditory nerve to the brain. Damage can make sound quieter and less clear. High frequencies are often affected first, making consonants and speech—especially in background noise—hard to understand.

Other effects can include poor localisation of sound, reduced discrimination, tinnitus and loudness intolerance or recruitment, in which a small increase in level feels disproportionately loud. Listening may require extra effort and lead to fatigue or social withdrawal.

This differs from conductive hearing loss, where sound is blocked or reduced in the outer or middle ear by causes such as wax, eardrum disease or middle-ear fluid. Some people have mixed hearing loss with both components.

Causes

Causes include ageing, repeated or intense noise, genetic conditions, infections such as meningitis or mumps, and medicines that can damage the inner ear. Ménière’s disease, diabetes and some neurological or autoimmune conditions can contribute. Sometimes the cause remains unknown.

Loss that is markedly different between the ears can occasionally be associated with a vestibular schwannoma or another problem along the auditory nerve and may require MRI. A stroke is a much less common cause and usually produces other neurological symptoms.

Treatment and rehabilitation

Many forms of permanent sensorineural loss cannot be reversed, but communication can often improve substantially. Options include appropriately fitted hearing aids, remote microphones, assistive listening devices, communication strategies and lip-reading or speech-reading support. Using two hearing aids is often helpful when both ears are aidable.

For severe or profound loss with limited benefit from hearing aids, assessment for a cochlear implant may be appropriate. Rehabilitation and realistic expectations are essential with every device.

Sudden hearing loss in one or both ears is a medical urgency. Contact a doctor or ENT service the same day, especially when accompanied by tinnitus, pressure or vertigo, because early assessment and treatment can matter.