Presentation
The following are various signs and symptoms of SNHL:
- Difficulty in appropriately following conversations of two individuals.
- Difficulty in hearing loud voice.
- Inability to hear clearly in areas with loud noise.
- Inability to clearly hear in areas where there is too much of background noise.
- Men’s voice appears to be clearer than women’s voice.
- Difficulty in demarcating high pitched sounds from one another.
In addition to the above mentioned symptoms, affected individuals may also experience the following:
Entire Body System
- Inflammation
The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after [ncbi.nlm.nih.gov]
Proctosigmoiditis is a result of chronic inflammation in the colon, like all types of ulcerative colitis. This inflammation is the result of an immune response. Doctors don’t know what triggers this immune response. [healthline.com]
- Pain
Loud sound can be very painful to a person with hearing loss. Try not to drop off your volume or tone at the end of sentences. There are many devices available for the management of hearing loss. [umm.edu]
His abdominal pain and diarrhea resolved, and he was discharged from hospital. [keio.pure.elsevier.com]
Localization and the nature of pains at a perisigmoiditis same, as well as at a sigmoiditis. The diagnosis is made on the basis of a clinical picture, data of physical, laboratory and tool researches. [en.medicalmed.de]
The low incidence (3%) of recurrent attacks of pain and fever is in favour of a resection limited to the sigmoid colon even when diffuse colonic diverticula are present.(ABSTRACT TRUNCATED AT 250 WORDS). [ncbi.nlm.nih.gov]
Symptoms include fever, abdominal pain and distention, dehydration and malnutrition. [ibdrelief.com]
- Falling
However, ratings always exceeded 3 for tones falling more than 1.5 octaves inside a DR. The results indicate that judgement of a tone as sounding noise-like does not reliably indicate that the tone frequency falls in a DR. [doi.org]
Falls are the most comon cause of traumatic brain injuries among adults aged 65 and older, but they are also commonly seen in sports. It is important to wear a helmet when playing contact sports or sports that have a risk of fall, such as bicycling. [hearinglikeme.com]
But this level of complexity means parts or processes can sometimes break down or fall out of step. The outcome can be hearing loss. There are a few reasons why this might happen. [nhc.com.au]
- Short Stature
The three related males described had varying degrees of cognitive impairment, sensorineural hearing loss, short stature, dysmorphic facies, and other morphological defects. [ncbi.nlm.nih.gov]
Gastrointestinal
- Constipation
Other symptoms associated with ulcerative colitis include: abdominal pain or rectal pain fever weight loss constipation rectal spasms You shouldn’t ignore rectal bleeding that is constant or bright red in appearance. [healthline.com]
Ears
- Tinnitus
Between April 2013 and March 2017, 1126 adult patients presented to the audiology department with asymmetrical sensorineural hearing loss and/or unilateral tinnitus. [ncbi.nlm.nih.gov]
Chronic tinnitus: relief of tinnitus (comparison 04) 4.1 Proportion of participants with improvement in tinnitus score See Analysis 4.1. [doi.org]
The aim of this study is to evaluate hearing characteristics in patients with and without tinnitus using DPOAE and specific tinnitus severity index (TSI) and tinnitus handicap inventory (THI) questionnaires in both groups. [clinicaltrials.gov]
- Hearing Impairment
There are two different types of hearing impairments, conductive hearing loss and sensorineural hearing loss. A third type is a combination of the two, called a mixed hearing loss. [dallashear.com]
While treatment depends on the specific condition, there are three main types of hearing impairment treatment. Wax Removal: If earwax blockage is the main cause of hearing impairment, this is an easy fix. [bluegrasshearing.com]
impairment View Full Text Statistics from Altmetric.com aetiological investigation aetiology survey hearing impairment One in 1000 children are born with a permanent hearing impairment and 50–90% more acquire a hearing impairment in early childhood.1 [adc.bmj.com]
Although TRIOBP alterations are not a frequent cause of hearing impairment, this gene should be thoroughly analyzed especially in patients with a postlingual hearing loss. [ncbi.nlm.nih.gov]
Both normally hearing and hearing-impaired subjects rated 0.125 kHz and 12 kHz tones as somewhat noise-like, independently of the existence of a DR. [doi.org]
- Sudden Hearing Loss
Bilateral sudden hearing loss is a rare initial symptom. In this article, we report a 44-year-old male patient with bilateral sudden hearing loss and dizziness. Magnetic resonance imaging showed involvement of the bilateral vestibulocochlear nerves. [ncbi.nlm.nih.gov]
hearing loss Cases of sudden sensorineural hearing loss after non-otological surgical procedures are rare. [pmj.bmj.com]
hearing loss (SSNHL), which is still commonly confused with idiopathic sudden deafness. [scielo.br]
Sudden hearing loss seriously affects patient's life and worsens his quality of life. Vascular, viral and autoimmune theory are most commonly mentioned as the cause of sudden hearing loss. [worldcat.org]
- Hearing Problem
Hearing Aids: When hearing problems are due to damage to the inner ear, a hearing device, like a hearing aid, may be beneficial. [bluegrasshearing.com]
You will probably be referred to an audiologist, a professional who specializes in diagnosing and treating hearing problems. The audiologist will conduct tests to determine the type and degree of your child's hearing problem. [texaschildrens.org]
[…] physical factors (as in trauma-induced problems, tumors, noise damage and drug-induced hearing loss) may play a role in hearing loss. [healthcentral.com]
About a third of adults older than 65—and half of those older than 85—have some hearing problem. It is the third most common chronic disease among older adults. Hearing loss is more than an inconvenience. [healthinaging.org]
Neurologic
- Vertigo
Abstract We present the case of a 33-year-old man who was admitted with intermittent ataxia, vertigo, and sensorineural hearing loss as a result of a vertebral artery dissection following minor neck trauma. [ncbi.nlm.nih.gov]
Patients with any asymmetric sensorineural hearing loss and unilateral tinnitus or dizziness/ vertigo are significantly more likely to have an abnormal MRI finding. [enttoday.org]
Workup
The following are the diagnostic procedures employed for detecting sensorineural hearing loss:
- Physical examination of the ear is done to detect infections or blockage due to physical objects or formation of ear wax.
- Tuning fork test is one of the best methods to judge SNHL. In this method, a Y-shaped metallic object is tapped and then held close to head for the individuals to hear the vibrating sound.
- Bone conduction test is specifically used for confirming SNHL. In this method, a vibrating probe is placed behind the ear.
- Molecular genetic testing may detect congenital forms of SNHL [10].
Treatment
The major goal of treatment is to improve the hearing ability of the affected individuals. In sensorineural hearing loss, the hearing loss cannot be completely restored. In this, since the nerve endings are damaged, the capability to hear sound clearly is greatly affected.
In mild cases, hearing aids work well for individuals suffering from mild to moderate hearing loss. For such individuals, telephone amplifiers are also known to be effective.
In severe cases, hearing aids do not work and therefore, a cochlear transplant is required. Post the procedure, the sounds appear louder but not clearer.
Prognosis
The prognosis of the condition greatly depends on the extent of damage to the nerve endings. Mild to moderate hearing loss may be treated with hearing aids that can help individuals to a certain extent. However, in severe cases, cochlear implants may be necessary as hearing aids may not be of much help. In many cases, no treatment regime can restore back the hearing ability.
Complications
Sensorineural hearing loss can adversely affect the quality of life. The inability to hear appropriately can give rise to the following conditions:
Etiology
SNHL is a nerve related hearing loss that basically occurs due to damage to the nerve that joins the inner ear to the brain. Several factors responsible for such a kind of hearing loss include the following:
- Immune conditions
- Exposure to high pitch sounds for longer duration on regular basis
- Certain medication that interfere with the hearing ability
- Disease such as Meniere’s disease and blood vessel disorders
- Injury
- Infectious conditions like meningitis, mumps, measles and scarlet fever, rubella [3]
- Old age
- Tumor
- Malformation of the inner ear can lead to congenital defect
- Genetic defects [2]
- Otosclerosis
- Congenital syndromes [4]
Though the chances are rare, but SNHL can be present at birth and is caused due to genetic defect or certain infections that are transferred from the mother to the baby. A significant number of SNHL among neonates have unknown etiology [5].
Epidemiology
The exact incidence of sensorinerual hearing loss is not known as many cases go unreported. With the limited data that is available, it can be estimated that such a type of hearing loss occurs in about 5 to 20 cases per 100,000 individuals. The average incidence of SNHL among neonates is 1.1 cases per 1000 births in the United States [6]. Men and women are affected in equal numbers by this condition.
Pathophysiology
The human ear contains tiny hairs which are also known as nerve endings that transform the sound into electric signals [7]. These signals are then carried by the nerves to the brain where they are interpreted as sound. In the condition of SNHL, the nerves that carry the information from the ear to the brain are damaged [8]. As a result, signals do not reach the brain for it to interpret the information as sound. Sequence of such events gives rise to hearing loss. In some syndromic cases of SNHLs, dysfunctional proteins have been identified in the transport of calcium and potassium ions [9].
Prevention
Individuals who are exposed to loud noises for longer duration are advised to wear protective devices to prevent their ears from damage due to the loud noise. Musicians are also advised to wear ear plugs to protect their ears from the loud noise of the musical instruments. Plexiglass baffles should also be used to reduce the noise from drummer’s high hat cymbals.
Summary
Sensorineural hearing loss, abbreviated as SNHL is one of the most common type of permanent hearing loss that occurs due to damage to the inner ear and the nerve that connects the inner ear to the brain. In SNHL, the individual has great difficulty in hearing faint sounds and even sounds that are loud enough to be heard, appear unclear to the affected individuals [1]. Prolonged exposure to loud noises is one of the greatest risk factors for development of SNHL.
Patient Information
Definition
Sensorineural hearing loss (SNHL) is a condition characterized by loss of hearing ability due to damage to the inner ear or the nerves that transform the signals from the ear to the brain. It is the most common cause of hearing loss. It has been estimated that 90% cases of hearing loss are sensorineural in nature. The condition can be managed with hearing aids for mild cases. Severe loss of hearing would require a cochlear transplant.
Cause
Cause of SNHL include damage to the inner ear due to loud noise, certain medications, disease conditions, immunity disorders, blood vessel diseases, tumors and infections.
Symptoms
Symptoms of SNHL include inability to clearly hear conversation between 2 individuals and inability to hear in places with loud noise. Individuals with SNHL are also unable to clearly hear certain types of sound and men’s voice appears to be clearer than women’s.
Diagnosis
Diagnosis of SNHL begins with a prior physical examination of the ear to rule out infections or blockages by physical objects or ear wax. Post this, the tuning fork test is carried out to examine the extent of damage to the ear. A more sophisticated technique known as the bone conduction test is done to confirm the diagnosis of sensorineural hearing loss.
Treatment
SNHL cannot be cured; however the hearing ability can be partially restored. Hearing aids are treatment of choice for mild to moderate hearing loss. In severe cases, cochlear implants may be necessary to help individuals hear. With the implants, the hearing ability is not completely restored and the noises appear to be louder enabling the individuals to hear to some extent.
References
- FDA approves first implantable hearing device for adults with a certain kind of hearing loss. US Food and Drug Administration; March 20, 2014.
- Eisen MD, Ryugo DK. Hearing molecules: contributions from genetic deafness. Cell Mol Life Sci. Mar 2007; 64(5):566-80.
- Saunders JE, Vaz S, Greinwald JH, Lai J, Morin L, Mojica K. Prevalence and etiology of hearing loss in rural Nicaraguan children. Laryngoscope. Mar 2007; 117(3):387-98.
- Huang BY, Zdanski C, Castillo M. Pediatric sensorineural hearing loss, part 2: syndromic and acquired causes. AJNR Am J Neuroradiol. Mar 2012; 33(3):399-406.
- Morzaria S, Westerberg BD, Kozak FK. Systematic review of the etiology of bilateral sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol. Sep 2004; 68(9):1193-8.
- Mehra S, Eavey RD, Keamy DG Jr. The epidemiology of hearing impairment in the United States: newborns, children, and adolescents. Otolaryngol Head Neck Surg. Apr 2009; 140(4):461-72.
- El-Amraoui A, Petit C. Usher I syndrome: unravelling the mechanisms that underlie the cohesion of the growing hair bundle in inner ear sensory cells. J Cell Sci. Oct 15 2005; 118:4593-603.
- Van Camp G, SmithR. Cloned genes for nonsyndromic hearing impairment. Hereditary Hearing Loss Journal.
- Brini M, Di Leva F, Domi T, Fedrizzi L, Lim D, Carafoli E. Plasma-membrane calcium pumps and hereditary deafness. Biochem Soc Trans. Nov 2007; 35 (pt 5):913-8.
- Usami SI, Nishio SY, Nagano M, Abe S, Yamaguchi T. Simultaneous Screening of Multiple Mutations by Invader Assay Improves Molecular Diagnosis of Hereditary Hearing Loss: A Multicenter Study. PLoS One. 2012; 7(2):e31276.