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What is sensorineural hearing loss?

The inner ear has two parts, one is the cochlea which converts the sound vibrations into electrical impulses

Sensorineural hearing loss is a very common type of hearing loss that affects people of all ages.

Many people develop hearing loss as they get older. This age-related hearing loss is a type of sensorineural hearing loss. However, sensorineural hearing loss can also be caused by genetic factors.

What does sensorineural hearing loss mean?

Sensorineural hearing loss means the inner ear or hearing nerve is damaged or unable to process sound as it should.

The inner ear and hearing nerve deliver a high-resolution signal to the brain for processing. If the inner ear is damaged, the sound's resolution is reduced, making the sound quieter and less precise.

This can be caused by damage to the tiny hair cells inside the cochlea, which is part of the inner ear that resembles a snail shell.

You can get a better understanding of how hearing works in this article about hearing loss.

What are the symptoms of sensorineural hearing loss?

If you have sensorineural hearing loss, you may experience one or more of the following:

  • difficulty understanding or hearing speech when there is background noise (e.g., at a restaurant or café)
  • a decreased tolerance for louder sounds, so they quickly become uncomfortable
  • you feel that people mumble or that sounds are not sharp
  • other people complain that your TV is too loud
  • you experience ringing in your ears (tinnitus)
  • you often ask others to repeat themselves
  • you have difficulty understanding people on the phone
  • other people notice that you do not hear well.

If you experience sensorineural hearing loss symptoms, you should have your hearing tested by a hearing care specialist.

Before you book an appointment with a hearing care specialist, you can check your hearing with an online hearing test.

What causes sensorineural hearing loss?

Sensorineural hearing loss can be acquired during a person’s life, or it can arise from genetic causes. Consequently, sensorineural hearing loss can affect people of all ages.

The most common causes of sensorineural hearing loss fall into the category of acquired hearing loss. Acquired hearing loss means that hearing loss happens after birth and throughout life. These causes of sensorineural hearing loss include:

Presbycusis or age-related hearing loss. This type of hearing loss occurs gradually over time as we get older, often resulting from damage to the tiny hair cells inside the cochlea (part of the inner ear). As the change happens gradually, it can take a long time for the person and their close ones to recognize the hearing loss.

Noise-induced hearing loss. Noise can cause serious damage to your ears. Depending on the loudness of the noise and the length of time you experience it, noise can cause temporary or permanent hearing loss. Some causes of noise-induced hearing loss include live concerts, listening to high sound levels with headphones, shooting, being close to power tools or loud equipment, motorcycling, snowmobiling, or working in noisy places such as construction sites and cafés.

Trauma. Head trauma or acoustic trauma can cause permanent hearing loss.

Head trauma can come from any accident which involves a blow to the head (e.g., a car accident, a bike accident, falling over, etc.).

Acoustic trauma results from an excessively loud sound, such as an explosion. The damage caused by acoustic trauma can include structural damage to the inner ear as well as noise-induced hearing loss.

Sudden sensorineural hearing loss. Sudden sensorineural hearing loss is a category of sensorineural hearing loss that occurs from one moment to the next. In some cases, people wake up with hearing loss. There are some known causes of sudden sensorineural hearing loss including viral infection, trauma, and diseases. However, sometimes no reason can be found.

Health factors. Several health factors increase the likelihood of acquiring hearing loss. These include diabetes, obesity, smoking, and high blood pressure.

What other causes of sensorineural hearing loss are there?

Sensorineural hearing loss can also occur due to genetic or other medical reasons. These can include:

Genetic disorders. Hearing loss can be part of many disorders (e.g., Waardenburg syndrome, Usher syndrome).

Hereditary reasons. Hearing loss can be hereditary. If you have a family history of hearing loss, it is a good idea to get your hearing checked regularly.

Congenital disorders. Congenital hearing loss means that it is present at birth. Babies can be born with genetic sensorineural hearing loss. Other hereditary or medically related causes of sensorineural hearing loss include ear malformations.

What other types of hearing loss are there?

Sensorineural hearing loss is a very common type of hearing loss. In addition to sensorineural hearing loss, another common type of hearing loss is conductive hearing loss.

Conductive hearing loss is caused by damage or an obstruction in the outer or middle ear that prevents the sound waves from being effectively gathered and conducted through the ear canal and into the inner ear.

Sometimes, people have both sensorineural hearing loss and conductive hearing loss at the same time. This is called mixed hearing loss.

You can find out more about the different types of hearing loss in our hearing loss terms guide.

The degrees of sensorineural hearing loss

The degree of sensorineural hearing loss a person can have falls into one of five categories:

  • mild hearing loss: 26 to 40 dB HL
  • moderate hearing loss: 41 to 55 dB HL
  • moderate-to-severe hearing loss: 56 to 70 dB HL
  • severe hearing loss: 71 to 90 dB HL
  • profound hearing loss: 91+ dB HL.

The greater the degree of hearing loss, the more significant the impact it will have on a person’s hearing ability.

How else can sensorineural hearing loss vary?

In addition to the degrees of sensorineural hearing loss listed above, there are other ways sensorineural hearing loss can differ from one person to another.

  • Some people with sensorineural hearing loss struggle to hear high-pitched sounds such as squealing brakes, while others have difficulty hearing different medium or low frequencies of sound.
  • Sensorineural hearing loss can also affect only one ear, which is called unilateral sensorineural hearing loss.
  • Some people have mixed hearing loss, which is where they have sensorineural hearing loss and conductive hearing loss at the same time.

What is it like to live with sensorineural hearing loss?

People’s experience of living with sensorineural hearing loss varies considerably, depending on their degree of hearing loss.

More mild types of sensorineural hearing loss may only have a small impact on daily life, while more severe sensorineural hearing loss can have a significant effect.

Mild hearing loss: Many of the soft daily sounds can be missed by someone with a mild hearing loss. Soft daily sounds include people breathing, leaves rustling, people whispering, refrigerators humming, cats purring and water dripping. Although people with mild sensorineural hearing loss can communicate well in quiet surroundings, they can confuse words starting with certain consonants (“s”, “f” or “th”) when they are in situations with background noise.

Moderate hearing loss: People with mild sensorineural hearing loss have more difficulty hearing and understanding speech at normal conversation levels. Following a conversation typically requires more effort, with many words possibly missed or misunderstood, even in a quiet situation. It may not be possible to follow a conversation at normal levels when in background noise. Other sounds that could be missed include people laughing, rain falling, and coffee brewing.

Moderate-to-severe hearing loss: People with moderate-to-severe hearing loss have difficulty understanding speech in most situations and have even more difficulty with noise. They usually find their TV or radio are not understandable at normal volume levels, and need to turn them up considerably. Other daily sounds that could be missed include water running, alarm clocks, children playing, busy streets, electric toothbrushes and washing machines.

Severe hearing loss: People with this degree of hearing loss have difficulty with most conversations at normal and moderately loud levels. Speech at loud levels might be understood as long as there is no competing background noise. Other daily sounds that could be missed include doorbells, phones, traffic noise, vacuum cleaners, toilets flushing, and the sounds of people working.

Profound hearing loss: People with this degree of hearing loss can only hear very loud sounds such as lawn mowers, motorcycles, ambulance sirens, or blenders. Speech at normal levels can’t be heard, and speech might not be audible or understood even when shouting. People with profound sensorineural hearing loss may rely on sign language or lip-reading to help them understand speech. They are generally candidates for cochlear implants.

How to treat sensorineural hearing loss

Hearing aids

The most common way to treat permanent sensorineural hearing loss is with hearing aids. Modern hearing aids are small and discreet electronic devices worn behind or in the ear, which amplify sound to make it louder and more precise. Hearing aids are programmed to the wearer’s specific hearing loss, so they provide each person with an individualized sound.

If you need hearing aids, your hearing care specialist can help you select the best hearing aid for your needs. To learn more about the different hearing aids and options, see this article on hearing aids.

Implantable devices

Other implantable devices called cochlear implants can be used to treat sensorineural hearing loss. Cochlear implants deliver sound to the brain by electrically stimulating the hearing nerve with tiny electrical impulses.

Cochlear implants include a tiny array that is implanted into the cochlea (inner ear organ) and a magnet that is surgically embedded in the skull, behind the ear. There is also an external receiver and hearing device. This is an option for people who have more significant hearing loss and receive little to no benefit from conventional hearing aids.

How can sensorineural hearing loss be prevented?

There are several things you can do to help prevent sensorineural hearing loss. If you already have some sensorineural hearing loss, you can also act to prevent it from getting worse over time.

Protect your hearing with hearing protection. Loud noise and sounds can cause hearing loss. Wearing hearing protection when taking part in noisy activities such as concerts, shooting and motorcycling will reduce the sound to safer levels. There are many types of hearing protection such as earplugs and earmuffs. A hearing care specialist can explain the options and help you find the right hearing protection that works best for your lifestyle.

Turn the volume down. When listening to music or other audio on your phone or other devices, it is crucial to keep the volume set at safe levels. Some audio devices allow you to set maximum limits for the volume. If you find you need to turn up the volume on your device because you are in a noisy situation, you could try noise-canceling headphones instead.

Get your hearing regularly tested. Monitoring your hearing for any changes in your hearing ability can identify signs of hearing loss. This is important because catching a mild hearing loss early may help you prevent it from developing into a more significant hearing loss that could have a greater impact on your life. An online hearing test is one easy way to monitor any changes to your hearing and can indicate if you should schedule a comprehensive hearing test.

Monitor your medication. Some medications can potentially be harmful to your hearing. These are called ototoxic medications. If you are on such a medication, it is crucial to monitor your hearing frequently for any changes. If possible, check with your physician about possible options that are not ototoxic.

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