Hearing Health Guide
Definition
Sensorineural hearing loss (SNHL) is damage to the sensory cells or nerve pathways of the inner ear that converts sound vibrations into electrical signals the brain can interpret. According to ASHA, it is the most prevalent form of permanent hearing loss in adults, accounting for approximately 90% of all cases of hearing loss.
The most common causes are noise exposure and aging. Noise-induced hearing loss damages cochlear hair cells through acoustic trauma; age-related loss (presbycusis) involves a gradual deterioration of these cells over a lifetime. Both processes are largely irreversible because hair cells in the human cochlea do not regenerate, according to the NIDCD.
Other causes include genetic conditions, certain medications (ototoxic drugs such as some chemotherapy agents and high-dose aminoglycoside antibiotics), viral infections (especially mumps and measles), Meniere's disease, and in rare cases, autoimmune disorders.
Sudden sensorineural hearing loss is a medical emergency: a loss of 30 dB or more over three consecutive frequencies within 72 hours. Treatment with corticosteroids within the first 48-72 hours significantly improves outcomes.
Sensorineural hearing loss typically produces a characteristic pattern on an audiogram: thresholds are elevated (shifted downward on the chart) at the affected frequencies. In the most common presentation (noise-induced or age-related), high-frequency thresholds (2,000-8,000 Hz) are affected first, producing a 'ski slope' or 'notch' pattern.
The audiogram will show that bone conduction and air conduction thresholds match. The signal is not being blocked in the middle ear; it is not being processed in the inner ear or nerve.
There is currently no medical cure that restores cochlear hair cells. The primary treatment for most adults with sensorineural hearing loss is amplification: hearing aids for mild to severe loss, or cochlear implants for profound loss where hearing aids are insufficient.
Since 2022, FDA-cleared over-the-counter (OTC) hearing aids are available without a prescription for adults with mild to moderate sensorineural hearing loss, significantly reducing the cost barrier to treatment.
Common Questions
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