Sensorineural hearing loss

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Sensorineural hearing loss
Cochlea-crosssection.png
Cross section of the cochlea.
ICD-10 H90.3-H90.5
ICD-9 389.1
DiseasesDB 2874
MeSH D006319

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centers of the brain.
The Weber test, in which a tuning fork is touched to the head, localizes to the normal ear in people with this condition. The Rinne test, which tests air conduction vs. bone conduction is positive (normal), though both bone and air conduction are reduced equally.

Differential diagnosis

Sensorineural hearing loss may be congenital or acquired.

Congenital

Acquired

  • Noise-induced - prolonged exposure to loud noises (>90 dB) causes hearing loss which begins at 4000Hz (high frequency). The normal hearing range is from 20 Hz to 20,000 Hz.
  • Presbyacusis - age-related hearing loss that occurs in the high frequency range (4000Hz to 8000Hz).
  • Meniere's disease - causes sensorineural hearing loss in the low frequency range (125 Hz to 1000 Hz). Meniere's disesase is characterized by sudden attacks of vertigo lasting minutes to hours preceded by tinnitus, aural fullness, and fluctuating hearing loss.



Table 1. A table comparing sensorineural to conductive hearing loss

Criteria Sensorineural hearing loss Conductive hearing loss
Anatomical Site Inner ear, cranial nerve VIII, or central processing centers Middle ear (ossicular chain), tympanic membrane, or external ear
Weber Test Sound localizes to normal ear Sound localizes to affected ear (ear with conductive loss)
Rinne Test Positive Rinne; Air conduction > Bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged). Negative Rinne; Bone Conduction > Air Conduction (Bone/Air Gap)

Treatment

At present, sensorineural hearing loss is treated with hearing aids, which amplify sounds at pre-set frequencies to overcome a sensorineural hearing loss in that range; or cochlear implants, which stimulate the cochlear nerve directly.

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