Sensorineural

Sensorineural is an adjective used in biology and medicine to describe disorders that involve the sensory receptors or the neural pathways that convey sensory information to the brain. In audiology, sensorineural hearing loss refers to impairment arising from damage to the inner ear (cochlea) or the auditory nerve, rather than to the external or middle ear.

Sensorineural problems may affect hair cells, the synapses between hair cells and spiral ganglion neurons, the auditory nerve fibers, or central auditory pathways in the brain. The onset can be congenital or acquired and may be acute, progressive, or chronic. Common causes include prolonged or excessive noise exposure, aging (presbycusis), ototoxic medications, infections, genetic conditions, head trauma, and diseases such as Ménière’s disease. In many cases the loss is permanent.

Diagnosis typically relies on audiometric testing showing reduced hearing sensitivity with intact middle-ear function. Pure-tone thresholds are elevated, speech discrimination may be reduced, otoacoustic emissions are often diminished, and the auditory brainstem response may reveal abnormal timing of neural conduction. Imaging may be used to evaluate retrocochlear or central causes when indicated.

Management aims to maximize residual hearing and communication ability. Options include hearing aids for amplification, cochlear implants for severe-to-profound loss, and assistive listening devices. Rehabilitation, communication strategies, and prevention of further damage (e.g., protecting against loud noise and avoiding ototoxic drugs when possible) are important. The prognosis varies with etiology and timeliness of intervention; some conditions respond to treatment if reversible, but most sensorineural losses are permanent.