What Is Sensorineural Hearing Loss?

What is sensorineural hearing loss?

Sensorineural hearing loss (SNHL) is the most common category of hearing loss to affect otherwise healthy adults. It occurs when there is a problem with the inner ear―most often the cochlea or associated structures―or the hearing nerve pathway that connects the inner ear to the brain. SNHL is usually permanent and irreversible, however it is generally treatable with hearing aids

What are the signs and symptoms of sensorineural hearing loss?

Early signs of sensorineural hearing loss include:

  • Increasing the volume of the television or radio to a point of discomfort for others
  • Difficulty understanding conversation in noisy environments
  • Feelings of self-consciousness or frustration as a result of struggling to hear or understand others
  • Regularly having to ask people to repeat themselves or speak up

During professional hearing assessments, most patients describe a sensation of diminished hearing. Other common complaints include a plugged-up feeling in their ear canal, ringing in the ears and vertigo or balance problems.

What causes sensorineural hearing loss?

As mentioned above, sensorineural hearing loss is generally the result of damage to the structures of the inner ear, which process soundwaves and turn them into electrical signals, and/or the auditory nerve pathway along which those signals are sent to the brain for interpretation. The damage can occur suddenly—either instantaneously or over the course of a few days—in a condition known as sudden sensorineural hearing loss. Let’s take a look at what can cause that kind of damage:

“Congenital” causes of sensorineural hearing loss refers to conditions that people are born with. The loss can be due to an infection or illness in the mother, hereditary hearing loss issues or other genetic conditions or syndromes that the child might have.

Exposure to loud noises can be another one of the causes of sensorineural hearing loss. Sudden loud noises, such as gunshots or explosions, can lead to immediate damage. But it’s also important to be aware that exposure to high decibel levels over long periods of time, whether in a noisy workplace or even through overuse of headphones or earbuds at high volumes, causes damage to the inner ear.

Limiting your exposure to sounds over 85 decibels and wearing hearing protection when you know you’ll be in loud environments can help protect your hearing over the long term.

Wear and tear on the body is a normal part of aging—and your ears are no exception. When it comes to age-related hearing loss, also known as presbycusis, sensorineural hearing loss is extremely common. It could be linked to years of exposure to loud noises, injury, illness, ototoxic medications—or any combination of those factors—but the end result is cumulative damage that interrupts your body’s ability to process sound.
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What are the types of sensorineural hearing loss?

Sensorineural hearing loss can be categorized in a few different ways:

Bilateral sensorineural hearing loss is when hearing loss caused by damage to the inner ear or auditory nerve occurs in both the left and the right ear. Its symptoms are the same as those generally associated with sensorineural hearing loss.

Unilateral sensorineural hearing loss (USHL) is the term used when the condition affects only one ear, either left or right. For people with USHL, it might be difficult to determine where sounds are coming from, and they might also experience unilateral tinnitus.

Asymmetrical sensorineural hearing loss refers to a situation in which a person has bilateral sensorineural hearing loss, but the loss is worse in one ear than the other. While it’s fairly common for hearing loss to vary between one ear and the other, significant differences of 10 dB or more are defined as asymmetrical.

Sudden sensorineural hearing loss (SSNL) is a condition in which hearing loss comes on rapidly, typically within 72 hours. It is a serious medical condition and should be considered an emergency situation. It typically occurs in one ear—but can occur in both—and might be accompanied by dizziness or tinnitus (ringing in the ears). As many as 90% of cases of SSNL have unknown causes, but it is sometimes associated with viral or bacterial infections, autoimmune diseases, acoustic neuroma, Lyme disease and multiple sclerosis. 

Conductive vs. sensorineural hearing loss

When comparing the differences between conductive vs. sensorineural hearing loss, the differentiating factors are the causes and the location of the problem. Conductive hearing loss is attributed to causes that prevent sound from moving through the outer and middle ear for processing. Those could include a ruptured eardrum or, more commonly, blockages like earwax or fluid buildup, the presence of foreign objects or congenital deformities.

On the other hand, sensorineural hearing loss occurs in the inner ear and is caused by damage to the anatomy that links the ears to the brain in the process of interpreting sound.

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How is sensorineural hearing loss diagnosed?

If you’ve noticed signs of hearing loss, even subtle ones, it’s a good idea to take a hearing test. An online hearing test can help determine whether you should go in for an in-person hearing test. A sensorineural hearing loss diagnosis can really only be done in person with a hearing care professional who’s trained to distinguish between types and degrees of hearing loss. They will administer a few painless tests, described below, to determine your level of hearing loss.

If you think you or a loved one may be experiencing hearing loss, schedule a free exam with a Miracle-Ear hearing specialist today.

Getting an in-person hearing test is one of the most important things you can do if you suspect you have hearing loss. During the test, a hearing care professional will examine your ears and conduct sound tests, including pure tone audiometry and speech discrimination.

Pure tone audiometry is the most common way that SNHL is diagnosed. It’s a type of hearing test conducted by a hearing specialist using a device known as an audiometer. You will listen to a range of sounds played through the audiometer and indicate which ones you can hear by pressing a button. The results of the test are presented as a graph known as an audiogram (see below).

In a speech discrimination test, you will be asked to repeat words that are said to you. Your hearing care specialist will interpret the combined results of these tests, as well as findings from the physical exam, in offering solutions and guiding your next steps toward better hearing. You can make an appointment online or by phone, or simply stop in to any of Miracle-Ear’s 1,500 neighborhood locations nationwide.

An audiogram is a graph that shows the results of your hearing test, visually plotting out your ability to hear variations in the intensity and pitch of sounds, as well as different frequencies. The X (horizontal) axis represents frequency and the Y (vertical) axis represents intensity.

You’ll see a variety of marks and lines on your audiogram; some will differentiate your right ear from your left ear, and others will indicate bone conduction (sound perceived through bone) versus air conduction (sound perceived through the air). A sensorineural hearing loss audiogram will differ from a conductive hearing loss audiogram, and your hearing care professional at Miracle-Ear is an expert at interpreting the subtleties of the results. Based on that information, they will help  you find solutions that address your unique hearing loss.

The Weber test can be used to indicate unilateral hearing loss, as well as being a first step in determining if you’re dealing with conductive or sensorineural hearing loss. In the test, a vibrating tuning fork is placed vertically at the top of your head or on the forehead and you are asked whether you can hear the tone equally in both ears. If you indicate that the tone sounds louder in one ear than the other, it suggests that there is unilateral hearing loss. To distinguish between conductive and sensorineural hearing loss, the Rinne test is performed. 

A Rinne test is an effective, quick method for testing for conductive hearing loss and is typically done in conjunction with a Weber test. In this test, which is done one ear at a time, a vibrating tuning fork is placed perpendicular to the head on the mastoid process (the bony protrusion at the base of the skull behind the ear).

The tester asks you to indicate when you can no longer hear the sound coming from the fork, then moves the fork parallel to your ear. You will then be asked again to state when you can no longer hear the vibration. The test is intended to determine whether you can hear better via air conduction or bone conduction; if bone conduction is better, it suggests that there is conductive hearing loss.

How can sensorineural hearing loss be treated?

Although sensorineural hearing loss is generally permanent, there are a number of treatment options available that will allow you to continue fully participating in your life. 

When it comes to treating sensorineural hearing loss, hearing aids are often the best tool for the job. The function of hearing aids—amplifying sound waves to compensate for lost natural hearing abilities—is ideal for aiding this type of hearing loss. The stronger vibrations that hearing aids direct into the ear help to create the electrical impulses that the body naturally sends to the brain, and which the brain then interprets and comprehends as speech or other sounds. 

The best type of hearing aid for sensorineural hearing loss will depend on a number of factors, including how severe your loss is.

The most powerful kind of hearing aids are typically behind-the-ear (BTE) models, which house all of the components in a small shell that fits behind the ear and connects to an earpiece. Receiver-in-canal (RIC) models are the most popular because of their blend of discreet size, comfort and versatility; they can be used by people with hearing loss that ranges from mild to severe.

The most discreet models, known as in-the-ear (ITE) or completely-in-canal (CIC) are barely visible but still provide powerful assistance for people with mild-to-moderate hearing loss. 

For people with severe to profound sensorineural hearing loss, cochlear implants can be a solution. These surgically implantable devices stimulate the auditory nerve directly—bypassing the damaged or nonfunctional parts of the ear—rather than sending amplified sound waves into the ear for processing. 

Bone conduction hearing aids for sensorineural hearing loss are not a popular option—they are typically better for people who have conductive hearing loss associated with the outer and middle ear. These devices, which are often designed as a headband that goes around the back of the head, or as over the ear or adhesive applications, conduct sound by sending vibrations through the bones of the head. These vibrations stimulate the cochlea which then sends signals to the brain.

Auditory training, or auditory rehabilitation, has long been a part of post-surgical care for people with cochlear implants, helping them to adapt to their improved ability to hear. However, more recently, scientists are exploring how it might also help hearing aid wearers and improve their experience.

A 2020 review of studies indicated that a combination of hearing aids and auditory training could be a helpful approach to improving communication skills. This approach is still relatively new and there are still questions about long-term efficacy for hearing aid wearers, but initial results show some promise.

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Think you may have SN hearing loss?

With proper professional guidance and a well-considered plan of intervention, it is possible to minimize the impact of sensorineural haring loss on your day-to-day life. Find a Miracle-Ear location near you today to discover your hearing support solutions.

FAQs about sensorineural hearing loss

Get quick answers to some of the most frequently asked questions about sensorineural hearing loss. 

Sensorineural hearing loss is typically permanent. Damage to nerves, hair cells or other structures of the inner ear are most often irreversible, which is why it’s important to do as much as you can to protect your hearing. 

Sensorineural hearing loss cannot typically be cured, but it can be treated. Using hearing aids is one of the best ways to address the loss and improve hearing. However, it’s important to remember that hearing aids “aid” hearing, rather than restore it, so you need to wear them consistently to get the most benefit from your investment.

Sensorineural hearing loss lasts for the rest of your lifetime after damage has occurred. Wearing hearing aids can make a significant difference in the ability to hear and elevate quality of life for people who have hearing loss.

Allergies are extremely unlikely to cause sensorineural hearing loss. They are much more likely to be associated with conductive hearing loss, in which swelling or fluid buildup inside the ears can lead to obstructed hearing.

Traumatic head injuries can result in sensorineural hearing loss. Head trauma that damages the structures of the inner ear or the parts of the brain that process sound can cause permanent sensorineural hearing loss.

Hearing aids are an excellent option for improving sensorineural hearing loss. People with this often-permanent condition benefit from hearing aids’ help in amplifying sound vibrations that are sent to the brain for processing. 

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