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Neurosensory (sensorineural) hearing loss
Last reviewed: 05.07.2025
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Sensorineural hearing loss (sensorineural hearing loss, perceptual hearing loss, cochlear neuritis) is a form of hearing loss in which any part of the sound-perceiving part of the auditory analyzer is affected, starting from the sensory cells of the inner ear and ending with the cortical representation in the temporal lobe of the cerebral cortex.
ICD-10 code
- H90 Sensorineural hearing loss:
- H90.3 Sensorineural hearing loss, bilateral;
- H90.4 Sensorineural hearing loss, unilateral, with normal hearing in the opposite ear;
- H90.5 Sensorineural hearing loss, unspecified (congenital deafness; hearing loss, neutral, neural, sensory; sensorineural deafness);
- H91 Other hearing loss:
- H91 Ototoxic hearing loss Use additional external cause code (Chapter XX) to identify toxic agent if needed;
- H91.1 Presbycusis (presbycusis);
- H91.2 Sudden idiopathic hearing loss (SUH NEC)
- H91.3 Mutational deafness, not elsewhere classified.
- H93 Other diseases of the ear, not elsewhere classified:
- H93.3 Diseases of the auditory nerve (lesions of the VIII cranial nerve).
Epidemiology of sensorineural hearing loss
About 6% of the world's population (278 million people) are deaf or have hearing problems. 80% of deaf people and people with hearing impairments live in low- and middle-income countries. 70-90.4% of patients with sensorineural hearing loss report tinnitus. Age-related changes significantly affect hearing. More than 30-35% of people between the ages of 65 and 75 have hearing loss, and in the age group over 75, this percentage increases to 60%.
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Causes of sensorineural hearing loss
Hearing impairments can be acquired or congenital. Numerous clinical observations and scientific studies have proven the role of:
- infectious diseases (flu and acute respiratory viral infections, infectious mumps, syphilis, etc.);
- vascular disorders (hypertension, vertebrobasilar dyscirculation, cerebral atherosclerosis);
- stressful situations;
- ototoxic effects of industrial and household substances, a number of drugs (aminoglycoside antibiotics, some antimalarial and diuretic drugs, salicylates, etc.);
- injuries (mechanical and acoustic, barotrauma).
Sensorineural (sensorineural) hearing loss - Causes and pathogenesis
Symptoms of sensorineural hearing loss
In patients with sensorineural hearing loss, the first complaint is always about hearing loss in one or both ears, which is often accompanied by subjective noise in the ear (ears). In acute hearing loss, a descending type of audiometric curve is observed in most cases. Quite often, patients show a positive phenomenon of accelerating loudness increase. In unilateral sensorineural hearing loss, the patient loses the ability to generalize sound in space. Bilateral hearing loss leads people to isolation, loss of emotional coloring of speech, and a decrease in social activity.
Where does it hurt?
What's bothering you?
Screening
Initial assessment of the auditory function requires analysis of acoumetric and audiological indicators, among which the mandatory ones are tuning fork tests and recording of a tonal threshold audiogram. On a tonal audiogram, various forms of audiometric curves can be observed depending on the frequencies at which hearing is changed.
The modern approach to diagnostics of hearing organ damage consists of conducting a multifaceted examination of the patient. To establish the cause of the disease and develop the most effective treatment tactics, a study of the function of the sound-perceiving system and vestibular analyzer is conducted, the state of the cardiovascular, excretory, endocrine systems and liver is assessed, and the indicators of the blood coagulation system are studied. An additional, more informative method that allows you to clarify the type of hearing loss is audiometry, performed in the frequency range above 8000 Hz.
Improvement of methods for diagnosing hearing loss is associated with the development of objective research methods, such as recording of SEP and delayed evoked OAE. The plan for examining patients with sensorineural hearing loss must include impedancemetry as a method for identifying the state of the middle ear structures.
An important component of the examination of patients with hearing impairment and, to a certain extent, prognostic for the outcome of treatment is the determination of the state of the vestibular apparatus.
Diagnosis of sensorineural hearing loss
In acquired sensorineural hearing loss, most patients do not have any warning signs of the disease. In some cases, hearing loss may be preceded by the appearance of noise or ringing in the ears.
Given the complexity of diagnosing sensorineural hearing loss, it is necessary to conduct a comprehensive general clinical examination of the patient with the participation of an otoneurologist, therapist, neurologist, ophthalmologist (to assess the condition of the fundus and retinal vessels), endocrinologist (to conduct glucose tolerance tests and thyroid function tests), and, if indicated, a consultation with a traumatologist.
What do need to examine?
Who to contact?
Treatment of sensorineural hearing loss
In acute sensorineural hearing loss, the most important goal is to restore hearing function. This goal can only be achieved if treatment is started as soon as possible. In chronic hearing loss, the goal of the treatment is to stabilize the reduced hearing function. In addition, social rehabilitation of people comes first in chronic sensorineural hearing loss. An individual approach to the treatment of sensorineural hearing loss is very important (the mental state, age, and the presence of concomitant diseases, etc. are taken into account).
Prevention of sensorineural hearing loss
Many external factors affect the organ of hearing. In this regard, the following is of great importance for the prevention of sensorineural hearing loss:
- elimination of the negative impact of household and professional (noise, vibration) hazards;
- elimination of alcohol and smoking;
- use of ototoxic drugs in children only for vital indications, with the simultaneous administration of antihistamines, vitamins and detoxification and other therapy;
- administration of detoxifying agents and agents that improve microcirculation to infectious patients with a high probability of developing sensorineural hearing loss and deafness.
Prognosis for sensorineural hearing loss
With early treatment of acute sensorineural hearing loss, the prognosis is favorable in approximately 50% of patients. In chronic sensorineural hearing loss, it is important to achieve hearing stabilization, and then carry out rehabilitation using hearing aids or cochlear implantation.