SensoriNeural Hearing Loss
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A loss of hearing can result from lesions in the external auditory canal, middle ear, inner ear, or central auditory pathways. Lesions in the external auditory canal or middle ear cause conductive hearing losses, while lesions in the inner ear or eighth nerve cause sensorineural hearing losses.
Conductive hearing losses result from obstruction of the external auditory canal by cerumen, debris, and foreign bodies; swelling of the lining of the canal; stenosis and neoplasms of the canal; perforations of the tympanic membrane, as in chronic otitis media; disruption of the ossicular chain, as occurs with necrosis of the long process of the incus in trauma or infection; fixation of the ossicles, as in otosclerosis; and fluid, scarring, or neoplasms in the middle ear.
Sensory hearing losses are due principally to damage to the hair cells of the organ of Corti caused by intense noise, viral infections, ototoxic drugs, fractures of the temporal bone, meningitis, cochlear otosclerosis, Ménière's disease, and aging. Neural hearing losses are due mainly to cerebellar angle tumours such as vestibular schwannomas (acoustic neuromas) but also may result from any neoplastic, vascular, demyelinating, infectious, or degenerative disease or trauma affecting the central auditory pathways.
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