What Is Sensorineural Hearing Loss and Can It Be Treated

What Is Sensorineural Hearing Loss and Can It Be Treated

Introduction

If you've been told you have sensorineural hearing loss, you're not alone. SNHL (sensorineural hearing loss) is the most common type of permanent hearing loss, affecting millions of Australians. It occurs when there's damage to the inner ear or the nerve pathways that carry sound signals to your brain.

Understanding what sensorineural hearing loss means, how it develops, and what treatment options are available can help you make informed decisions about your hearing health. While SNHL is typically permanent, modern hearing solutions can help most people hear clearly again and stay connected to the conversations that matter.

What is Sensorineural Hearing Loss?

Sensorineural hearing loss (SNHL) is a type of hearing loss caused by damage to the inner ear (cochlea) or the auditory nerve pathways that connect your inner ear to your brain. The term "sensorineural" refers to the sensory organ (the cochlea) and the neural pathways (auditory nerve) that process sound.

Unlike conductive hearing loss, which involves problems in the outer or middle ear that block sound from reaching the inner ear, SNHL affects your ability to process and interpret sounds even when they reach your inner ear. This type of hearing loss is usually permanent because the delicate hair cells in the cochlea don't regenerate once damaged.

The Difference Between SNHL and Other Types

There are three main types of hearing loss:

• Sensorineural hearing loss: Damage to the inner ear (cochlea) or auditory nerve
• Conductive hearing loss: Blockage or damage in the outer or middle ear
• Mixed hearing loss: A combination of both sensorineural and conductive hearing loss

SNHL is by far the most common type, accounting for about 90% of all hearing loss cases in adults.

How the Inner Ear Works

To understand sensorineural hearing loss, it helps to know how your inner ear processes sound.

The Journey of Sound

1. Sound waves enter your ear canal and cause your eardrum to vibrate

2. These vibrations pass through three tiny bones in your middle ear (the ossicles)

3. The vibrations reach your cochlea, a snail-shaped organ filled with fluid in your inner ear

4. The fluid movement stimulates thousands of tiny hair cells (stereocilia) inside the cochlea

5. These hair cells convert the mechanical vibrations into electrical signals

6. The auditory nerve carries these signals to your brain, where they're interpreted as sound

When Hair Cells Are Damaged

The cochlea contains roughly 15,000 hair cells, each tuned to detect specific sound frequencies. When these delicate hair cells become damaged or die, they can't regenerate. This is why sensorineural hearing loss is typically permanent.

High-frequency hair cells (located at the base of the cochlea) are particularly vulnerable to damage, which is why many people with SNHL first notice difficulty hearing high-pitched sounds like women's voices, children's speech, or birds chirping.

Common Causes of Sensorineural Hearing Loss

Sensorineural hearing loss can develop from a variety of causes, and in some cases, the exact cause may not be identified.

Age-Related Hearing Loss (Presbycusis)

The most common cause of SNHL is the natural ageing process. Presbycusis typically develops gradually over many years and affects both ears equally. Research suggests that age-related changes can affect the hair cells, the auditory nerve, and the way your brain processes sound.

Noise Exposure

Prolonged exposure to loud sounds or a single exposure to an extremely loud sound (acoustic trauma) can damage the delicate hair cells in your cochlea. This might include:

• Occupational noise (construction, manufacturing, aviation)
• Recreational noise (concerts, power tools, firearms)
• Personal audio devices at high volumes

Genetic Factors

Some people are born with genetic variations that may increase their susceptibility to hearing loss, or may develop hearing loss due to hereditary conditions. Family history can play a role in both early-onset and age-related SNHL.

Medications (Ototoxicity)

Certain medications can damage the structures of the inner ear. These ototoxic drugs may include:

• Some antibiotics (particularly aminoglycosides)
• High doses of aspirin
• Some chemotherapy drugs
• Loop diuretics (in high doses)

If you're taking any medications and notice changes in your hearing, consult your doctor. They may be able to adjust your treatment plan.

Sudden Sensorineural Hearing Loss

In rare cases, SNHL can develop suddenly—often in one ear—over a period of hours or days. Sudden sensorineural hearing loss requires prompt medical attention, as early intervention may improve outcomes. Possible causes include viral infections, immune system disorders, or circulation problems affecting the inner ear.

Other Medical Conditions

Several health conditions have been associated with increased risk of hearing loss, though the exact mechanisms aren't always fully understood. These may include cardiovascular disease, diabetes, and autoimmune disorders. If you have any ongoing health conditions, discuss your hearing health with your healthcare team.

Head Trauma

A severe blow to the head can damage the inner ear structures or the auditory nerve pathways, potentially resulting in sensorineural hearing loss.

Acoustic Neuroma

An acoustic neuroma is a benign (non-cancerous) tumour that grows on the auditory nerve. As it grows, it can interfere with hearing and balance. Treatment options may include monitoring, radiation therapy, or surgical removal.

Signs and Symptoms of SNHL

Sensorineural hearing loss often develops gradually, so you might not notice it at first. Common signs include:

Communication Difficulties

• Frequently asking people to repeat themselves
• Finding conversations difficult to follow, especially in groups or noisy environments
• Hearing people speak but struggling to understand what they're saying
• Turning up the TV or radio volume beyond what others find comfortable

Sound Quality Changes

• High-pitched sounds (women's voices, birds, beeps) becoming harder to hear
• Speech sounding muffled or unclear, as if people are mumbling
• Difficulty distinguishing similar-sounding words (like "cat" and "hat")

Social and Emotional Effects

Many people with sensorineural hearing loss find themselves:

• Avoiding social situations because conversations feel too challenging
• Feeling tired after concentrating hard to hear and understand speech
• Feeling isolated or left out during family gatherings or social events

Additional Symptoms

You might also experience:

• Tinnitus: Ringing, buzzing, or other sounds in your ears
• Sensitivity to loud sounds: Some frequencies might feel uncomfortably loud
• Balance issues: In cases where the inner ear's vestibular system is also affected

If you recognise any of these signs, a comprehensive hearing assessment with a qualified audiologist can help determine the nature and extent of your hearing loss.

Diagnosis: Understanding Your Audiogram

The primary tool for diagnosing sensorineural hearing loss is a comprehensive hearing assessment, which produces a visual representation of your hearing called an audiogram.

What Happens During a Hearing Assessment

A thorough hearing evaluation typically includes:

1. Case history: Discussion of your hearing concerns, medical history, and noise exposure

2. Otoscopy: Visual examination of your ear canal and eardrum

3. Pure-tone audiometry: Testing how well you hear different frequencies at various volumes

4. Speech audiometry: Assessing how well you understand speech at different volumes

5. Tympanometry: Measuring how your middle ear responds to air pressure changes

Reading Your Audiogram

An audiogram is a graph that shows your hearing thresholds (the quietest sounds you can hear) across different frequencies. Here's what the results mean:

• Horizontal axis: Shows frequency (pitch) in Hertz, from low (250 Hz) to high (8000 Hz)
• Vertical axis: Shows intensity (loudness) in decibels (dB), from quiet (top) to loud (bottom)
• X and O symbols: Represent your hearing thresholds for each ear

Hearing Loss Categories

The degree of hearing loss is typically classified as:

• Normal hearing: 0-20 dB
• Mild hearing loss: 21-40 dB
• Moderate hearing loss: 41-55 dB
• Moderately severe: 56-70 dB
• Severe hearing loss: 71-90 dB
• Profound hearing loss: 91+ dB

Distinguishing SNHL from Other Types

Your audiologist can determine whether hearing loss is sensorineural, conductive, or mixed by comparing air conduction results (sound delivered through headphones) with bone conduction results (sound delivered through a small vibrator placed behind your ear).

In sensorineural hearing loss, both air and bone conduction thresholds show similar patterns of hearing loss. In conductive hearing loss, bone conduction thresholds are better than air conduction thresholds, indicating a problem in the outer or middle ear.

Treatment Options for Sensorineural Hearing Loss

While sensorineural hearing loss is typically permanent, many treatment options can help improve your hearing and quality of life.

Hearing Aids

Hearing aids are the most common and effective treatment for the majority of people with SNHL. Modern hearing aids are sophisticated devices designed to amplify sounds in a way that's customised to your specific hearing loss pattern.

How Hearing Aids Help with SNHL

Digital hearing aids can:

• Amplify the specific frequencies where you have hearing loss
• Reduce background noise to improve speech understanding
• Adapt automatically to different listening environments
• Stream audio directly from phones, TVs, and other devices
• Help prevent further auditory processing decline

Types of Hearing Aids

• Behind-the-ear (BTE): Sits behind the ear with a tube connecting to an earmould or dome
• Receiver-in-canal (RIC): Similar to BTE but with the speaker sitting in the ear canal
• In-the-ear (ITE): Custom-made to fit in the outer ear
• In-the-canal (ITC): Smaller custom device that fits partly in the ear canal
• Completely-in-canal (CIC): Very small device that fits deep in the ear canal

The type that's right for you depends on your degree of hearing loss, ear anatomy, lifestyle needs, and preferences.

Cochlear Implants

For people with severe to profound sensorineural hearing loss who receive limited benefit from hearing aids, cochlear implants may be an option.

How Cochlear Implants Work

Unlike hearing aids that amplify sound, cochlear implants bypass the damaged hair cells and directly stimulate the auditory nerve. The device consists of:

• External components: Microphone, speech processor, and transmitter worn behind the ear
• Internal components: Receiver implanted under the skin and electrode array inserted into the cochlea

Cochlear implants require surgery and a period of adjustment and auditory rehabilitation. Candidacy is determined through comprehensive evaluation by an audiologist and ear, nose, and throat specialist.

Assistive Listening Devices

In addition to hearing aids, various assistive technologies can help in specific situations:

• FM systems: Transmit sound directly from a microphone to your hearing aids
• Loop systems: Used in theatres, churches, and public venues
• Amplified telephones: Feature extra amplification and tone control
• Alerting devices: Visual or vibrating alerts for doorbells, alarms, and phones

Communication Strategies

Learning effective communication strategies can complement technological solutions:

• Position yourself to see the speaker's face
• Reduce background noise when possible
• Ask people to speak clearly (not necessarily louder)
• Repeat back what you've heard to confirm understanding
• Advocate for your communication needs

Tinnitus Management

Since many people with SNHL also experience tinnitus, your treatment plan might include:

• Sound therapy using hearing aids or specialized devices
• Counselling and cognitive behavioural approaches
• Relaxation techniques
• Addressing underlying factors like stress or sleep issues

Research and Emerging Treatments

While current treatments focus on managing SNHL rather than reversing it, researchers are exploring potential future treatments including:

• Hair cell regeneration techniques (currently in research phases)
• Gene therapy approaches
• Stem cell research
• Pharmaceutical interventions

These approaches remain experimental and are not yet available as standard treatment options.

Living with Sensorineural Hearing Loss

Adjusting to sensorineural hearing loss and treatment is a journey that takes time, patience, and support.

The Adjustment Period

If you're fitted with hearing aids, give yourself time to adjust. Your brain needs to relearn how to process sounds you haven't heard clearly in a while. This adaptation period typically takes several weeks to months.

During this time:

• Wear your hearing aids consistently to help your brain adjust
• Start in quieter environments before tackling noisier situations
• Attend follow-up appointments so your audiologist can fine-tune your devices
• Be patient with yourself—hearing is a complex process involving both your ears and brain

Protecting Your Remaining Hearing

Once you have hearing loss, protecting your remaining hearing becomes especially important:

• Wear hearing protection in loud environments (concerts, power tools, lawn mowing)
• Follow the 60/60 rule for personal audio devices: no more than 60% volume for 60 minutes at a time
• Take listening breaks when you're in noisy environments
• Maintain overall health: Some evidence suggests cardiovascular health may influence hearing health

Staying Connected

Sensorineural hearing loss doesn't have to mean social isolation. With appropriate treatment and support:

• Most people can continue enjoying conversations, social events, and entertainment
• Technology continues to improve, making communication easier
• Support groups and counselling can help you adjust emotionally
• Family education helps your loved ones understand how to communicate effectively with you

Regular Follow-Up Care

Hearing can change over time, and hearing aid technology continues to advance. Regular appointments with your audiologist help ensure:

• Your hearing aids are working optimally
• Settings are adjusted as your hearing changes
• You're aware of new technologies that might benefit you
• Any new hearing concerns are addressed promptly

Take the Next Step

If you're concerned about sensorineural hearing loss or experiencing any symptoms discussed in this article, we're here to help. A comprehensive hearing assessment can provide clarity about your hearing health and help you understand what options might be right for you.

Book your complimentary hearing assessment today. Our experienced team takes the time to understand your hearing concerns, explain your results clearly, and discuss solutions that fit your lifestyle and budget. There's no obligation—just honest advice and professional care.