What is "sensorineural hearing loss"

n. hearing loss due to failure of the auditory nerve [syn: nerve deafness]

Sensorineural hearing loss (SNHL) is a type of hearing loss, or deafness, in which the root cause lies in the inner ear or sensory organ ( cochlea and associated structures)or the vestibulocochlear nerve ( cranial nerve VIII)or neural part. SNHL accounts for about 90% of hearing loss reported. SNHL is generally permanent and can be mild, moderate, severe, profound, or total. Various other descriptors can be used such as high frequency, low frequency, U-shaped, notched, peaked or flat depending on the shape of the audiogram, the measure of hearing.

Sensory hearing loss occurs as a consequence of damaged or deficient cochlear hair cell function. The hair cells may be abnormal at birth, or damaged during the lifetime of an individual. There are both external causes of damage, like noise trauma and infection, and intrinsic abnormalities, like deafness genes. A common cause or exacerbating factor in sensory hearing loss is prolonged exposure to environmental noise, for example, being in a loud workplace without wearing protection, or having headphones set to high volumes for a long period. Exposure to a very loud noise such as a bomb blast can cause noise-induced hearing loss.

Neural, or 'retrocochlear', hearing loss occurs because of damage to the cochlear nerve (CVIII). This damage may affect the initiation of the nerve impulse in the cochlear nerve or the transmission of the nerve impulse along the nerve into the brainstem.

Most cases of SNHL present with a gradual deterioration of hearing thresholds occurring over years to decades. In some the loss may eventually affect large portions of the frequency range. It may be accompanied by other symptoms such as ringing in the ears( tinnitus), dizziness or lightheadedness( vertigo). SNHL can be inherited (genetic))or acquired(result from external causes like noise or disease). It may be congenital (present at birth) or develop later in life. The most common kind of sensorineural hearing loss is age-related ( presbycusis), followed by noise-induced hearing loss(NIHL).

Frequent symptoms of SNHL are loss of acuity in distinguishing foreground voices against noisy backgrounds, difficulty understanding on the telephone, some kinds of sounds seeming excessively loud or shrill ( recruitment), difficulty understanding some parts of speech ( fricatives and sibilants), loss of directionality of sound, esp. high frequency sounds, perception that people mumble when speaking, and difficulty understanding speech. Similar symptoms are also associated with other kinds of hearing loss; audiometry or other diagnostic tests are necessary to distinguish sensorineural hearing loss.

Identification of sensorineural hearing loss is usually made by performing a pure tone audiometry (an audiogram) in which bone conduction thresholds are measured. Tympanometry and speech audiometry may be helpful. Testing is performed by an audiologist.

There is no proven or recommended treatment or cure for SNHL; management of hearing loss is usually by hearing strategies and hearing aid. In cases of profound or total deafness, a cochlear implant is a specialised hearing aid which may restore a functional level of hearing. SNHL is at least partially preventable by avoiding environmental noise, ototoxic chemicals and drugs, and head trauma, and treating or inoculating against certain triggering diseases and conditions like meningitis.