Sensorineural Hearing Loss
Linnea Cheung, David Baguley, Andrew McCombe
Abstract
Sensorineural hearing loss (SNHL) is hearing impairment resulting from damage to the cochlear hair cells and/or impairment of the sensory nerve fibres of the inner ear. The main aim in evaluating a patient with SNHL is to identify any treatable causes, and the provision of supportive treatment. Guidance should be given to patients to optimise their acoustic environment, and they should be offered psychological counseling if their HL is having a negative impact on their mood. Oral steroids are the standard treatment of SSNHL despite systematic reviews and meta-analyses revealing limited evidence of benefit. Agents affecting ion transport across epithelia, such as loop diuretics, cause oedema of the stria vascularis. Toxic effects usually appear after repeated systemic treatment, although even a single topical application to the middle ear cavity can initiate damage.