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Sensorine (sensorineural) hearing loss
Last reviewed: 23.11.2021
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Sensorineural hearing loss (sensorineural hearing loss, perceptual hearing loss, cochlear neuritis) is a form of hearing loss in which any of the parts of the sound-sensing part of the auditory analyzer is affected, from the sensory cells of the inner ear to the cortical representation in the temporal lobe of the cerebral cortex.
ICD-10 code
- Н90 Sensorine hearing loss:
- H90.3 Sensorineural hearing loss is bilateral;
- H90.4 Sensorineural hearing loss is one-sided with normal hearing on the opposite ear;
- H90.5 Sensorineural hearing loss, unspecified (congenital deafness, hearing loss is neutral, neural, sensory, neurosensory deafness);
- H91 Other hearing loss:
- H91. Ototoxic hearing loss. If necessary, an additional code of external causes (class XX) is used to identify the toxic agent;
- H91.1 Presbyacusis (presbybicusis);
- H91.2 Sudden idiopathic hearing loss (sudden loss of hearing of the BDU)
- H91.3 Mutational deafness, not elsewhere classified.
- H93 Other ear disorders, not elsewhere classified:
- H93.3 Diseases of the auditory nerve (defeat of the VIII cranial nerve).
Epidemiology of sensorineural hearing loss
About 6% of the world's population (278 million people) suffer from deafness 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 suffering from sensorineural hearing loss, note tinnitus. Age-related changes greatly affect the state of 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 is increased to 60%.
[Causes of sensorineural hearing loss
Hearing disorders can be acquired and congenital. In the emergence of acquired neurosensory hearing loss, numerous clinical observations and scientific studies have proved the role:
- infectious diseases (influenza and SARS, infectious parotitis, syphilis, etc.);
- cardiovascular disorders (hypertension, vertebral-basilar dyskirculation, cerebral atherosclerosis);
- stressful situations;
- ototoxic effects of industrial and household substances, a number of medications (antibiotics of the aminoglycoid series, some antimalarial and diuretics, salicylates, etc.);
- injuries (mechanical and acoustic, barotrauma).
Sensorine (sensorineural) hearing loss - Causes and pathogenesis
Symptoms of sensorineural hearing loss
In patients with sensorineural hearing loss, complaints of hearing loss on one or both ears, which is often accompanied by subjective noise in the ear (ears), always come first. In acute hearing loss in most cases, a downward type of an audiometric curve is observed. It is quite often that a positive phenomenon of accelerating the increase in loudness is revealed in patients. With one-sided sensorineural hearing loss, the patient loses the ability to lateralize sound in space. Bilateral loss of hearing leads people to isolation, loss of emotional coloring of speech, a decrease in social activity.
Where does it hurt?
What's bothering you?
Screening
The initial evaluation of the auditory function requires an analysis of the acoustic and audiological indicators, among which compulsory sampling is the conductance of a tone threshold audiogram. On the tonal audiogram, various forms of audiometric curves can be observed, depending on the frequencies at which the hearing is changed.
The modern approach to the diagnosis of lesions of the hearing organ is to conduct a multidisciplinary examination of the patient. To determine the cause of the disease and develop the most effective therapeutic tactics, the function of the sound-receiving system and the vestibular analyzer is examined, the state of the cardiovascular, excretory, endocrine and liver systems is evaluated, and the parameters of the blood coagulation system are studied. An additional, more informative method that makes it possible to clarify the type of hearing loss is the audiometry performed in the frequency range above 8000 Hz.
Improving the methods of diagnosing hearing loss is associated with the development of objective research methods, such as the registration of SVPs and delayed UAE caused. In the plan of examination of patients with sensorineural hearing loss, the inclusion of impedanceometry is necessary. As a method of revealing the state of the structures of the middle ear.
An important component of the examination of patients with hearing impairment and, to some extent, prognostic for the result of treatment is the determination of the state of the vestibular apparatus.
Diagnosis of sensorineural hearing loss
With acquired sensorineural hearing loss, most patients do not have any precursors 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 the diagnosis of neurosensory hearing loss, it is necessary to conduct a comprehensive clinical examination of the patient with the participation of an otoneurologist, a therapist. Neurologist, ophthalmologist (to assess the condition of the fundus and retinal vessels). Endocrinologist (for carrying out tests for glucose tolerance and thyroid function studies), as well as on indications, consultation of a traumatologist.
What do need to examine?
Who to contact?
Treatment of sensorineural hearing loss
With acute sensorineural hearing loss, the most important goal is the restoration of the auditory function. Achieving this goal is possible only with the beginning of treatment in the shortest possible time. With chronic impairment of the auditory function, the goal of the treatment is to stabilize the decreased auditory function. In addition, the first place for chronic sensorineural hearing loss is the social rehabilitation of people. Individual approach in the treatment of neurosensory hearing loss is very important (the state of mind, age and the presence of concomitant diseases, etc.) are taken into account.
Prophylaxis of sensorineural hearing loss
Many external factors affect the hearing organ. In this regard, for the prevention of neurosensory hearing loss is of great importance:
- elimination of the negative impact of domestic and professional (noise, vibration) hazards;
- exclusion of alcohol and smoking;
- the use of ototoxic medicines in children only for life indications, with the simultaneous administration of antihistamines. Vitamins and detoxification of other therapy;
- the use of detoxification agents and microcirculation improvers, an infectious patient with a high probability of neurosensory deafness and deafness.
Prognosis with sensorineural hearing loss
At the early onset of treatment of acute sensorineural hearing loss, the prognosis is favorable in about 50% of patients. In case of chronic sensorineural hearing loss, it is important to achieve hearing stabilization, and then to carry out rehabilitation with the methods of hearing aid or cochlear implantation.