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A conductive hearing loss is caused by any condition or disease that impedes the conveyance of sound in its mechanical form through the middle ear cavity to the inner ear. The reason for sensorineural hearing loss sometimes cannot be determined, it does not typically respond favorably to medical treatment, and it is typically described as an irreversible, permanent condition.
A mixed hearing loss can be thought of as a sensorineural hearing loss with a conductive component overlaying all or part of the audiometric range tested.
The conductive component may be amenable to medical treatment and reversal of the associated hearing loss, but the sensorineural component will most likely be permanent. Sensorineural hearing loss is another type of hearing loss also known as SNHL or Sensor neural hearing loss. Mixed hearing loss is the type of hearing loss that conductive hearing loss and sensorineural hearing loss is in combination. As an overview, low frequency (or tone) sensorineural hearing loss (LF SNHL or LT SNHL) is unusual, and mainly reported in Meniere's disease as well as related conditions such as low CSF pressure.
Le Prell et al (2011) suggested that low frequency hearing loss was detected in 2.7% of normal college student's ears. Oishi et al (2010) suggested that about half of patients with LTSNHL developed high or flat hearing loss within 10 years of onset.
The new international criteria for Meniere's disease require observation of a low-tone SNHL. Gatland et al (1991) reported fluctuation in hearing at low frequencies with dialysis was common, and suggested there might be treatment induced changes in fluid or electrolyte composition of endolymph (e.g.
Although OAE's are generally obliterated in patients with hearing loss > 30 dB, for any mechanism other than neural, this is not always the case in the low-tone SNHL associated with Meniere's disease. The lack of universal correspondence between audios and OAE's in low-tone SNHL in at least some patients with Meniere's, suggests that the mechanism of hearing loss may not always be due to cochlear damage.
Of course, in a different clinical context, one might wonder if the patient with the discrepency between OAE and audiogram might be pretending to have hearing loss. Papers are easy to publish about genetic hearing loss conditions, so the literature is somewhat oversupplied with these. Bespalova et al (2001) reported that low frequency SNHL may be associated with Wolfram syndrome, an autosomal recessive genetic disorder (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). Bramhall et al (2008) a reported that "the majority of hereditary LFSNHL is associated with heterozygous mutations in the WFS1 gene (wolframin protein). Eckert et al(2013) suggested that cerebral white matter hyperintensities predict low frequency hearing in older adults. Fukaya et al (1991) suggested that LFSN can be due to microinfarcts in the brainstem during surgery. Ito et al (1998) suggested that bilateral low-frequency SNHL suggested vertebrobasilar insufficiency. Yurtsever et al (2015) reported low and mid-frequency hearing loss in a single patient with Susac syndrome. There are an immense number of reports of LTSNHL after spinal anesthesia and related conditions with low CSF pressure. Fog et al (1990) reported low frequency hearing loss in patients undergoing spinal anesthesia where a larger needle was used.
Waisted et al (1991) suggested that LFSNHL after spinal anesthesia was due to low perilymph pressure.
Wang et al reported hearing reduction after prostate surgery with spinal anesthesia (1987). We have encountered a patient, about 50 years old, with a low-tone sensorineural hearing loss that occured in the context of a herpes zoster infection (Ramsay-Hunt). LTSNHL is generally viewed as either a variant of Meniere's disease or a variant of sudden hearing loss, and the same medications are used.
Determining the type and causes of hearing loss depends on where the hearing loss takes place in the ear. Conductive hearing losses (CHL) are identified within NewSound Hearing Aid Centers comprehensive otoscopic examination and audiometic testing. Comprehensive audiometric testing will ascertain the levels of hearing loss at multiple individual frequencies in each ear resulting in a graph called an Audiogram. Mixed hearing losses contain a combination of conductive and sensorineural loss components. There are many potential causes of hearing loss regardless of the type from which you suffer. After initial hearing aid fitting, patients may find that it takes several weeks to adjust to the new hearing. If the hearing loss is profound, that is unaidable with a powerful hearing aid, then the patient may be a candidate for a cochlear implant.
If you have any questions about Sensorineural Hearing Loss, treatment, billing, or insurance, please feel free to call Dr.


The Comfort Duett is an easy-to-use hearing amplifier that helps you get more involved in almost any situation, whether you're at a lively family dinner, chatting on the phone or watching TV. The compact, rechargeable Comfort Duett catches important sounds, like people's voices, and sends loud, crisp audio to earbuds, headphones or T-coil hearing aids. A conductive hearing loss can be the result of a blockage in the external ear canal or can be caused by any disorder that unfavorably effects the middle ear’s ability to transmit the mechanical energy to the stapes footplate. Generally, the cause of conductive hearing loss can be identified and treated resulting in a complete or partial improvement in hearing.
The sensory component may be from damage to the organ of Corti, an inability of the hair cells to stimulate the nerves of hearing or a metabolic problem in the fluids of the inner ear. Like conductive hearing loss, sensorineural hearing loss reduces the intensity of sound, but it might also introduce an element of distortion into what is heard resulting in sounds being unclear even when they are loud enough. So, in addition to some irreversible hearing loss caused by an inner ear or auditory nerve disorder, there is also a dysfunction of the middle ear mechanism that makes the hearing worse than the sensorineural loss alone. Hearing aids can be beneficial for individuals with a mixed hearing loss, but caution must be exercised by the hearing care professional if the conductive component is due to an active ear infection. Sounds waves may travel through the ear but this nerve pathway is unable to send electrical impulses to the brain. To us, this seems a little overly stringent, compared to the earlier 1995 AAO criteria that just required any kind of hearing loss, but criteria are better than no criteria. That being said, genetic conditions should not be your first thought when you encounter a patient with LTSNHL. One would think that diabetes insipidus is so rare that hearing loss is probably not the main reason these individuals are seeking attention.
These patients are extremely rare because there isn't much microsurgery done close to the brainstem. We are dubious about the conclusion of this paper because it is different than nearly every other paper in the literature. We are dubious that this has any applicability to humans and we have never seen a patient with lithium toxicity with any LFSNHL. We have observed this occasionally ourselves, but of course, the usual pattern is a conductive hyperacusis. We find this somewhat plausible as pregnancy and delivery might be associated with spinal anesthesia, with changes in collagen, and with gigantic changes in hormonal status. Today, 25 percent of adults age 45-64 and 40 percent of adults age 65 and older suffer from some degree of measurable hearing impairment.
In normal hearing, sound enters the ear canal and vibrates the tympanic membrane (TM, also called the ear drum). Equally important, full testing will also indicate a patient’s level of speech comprehension. To determine the type of loss you or a loved one may have, it is best to visit a hearing clinic for a comprehensive otoscopic and audiometric evaluation. The type of hearing aid in terms of power, size, options, and costs are best determined by you and your audiologist. Moreover, with the small discreet hearing aids available today, one is more likely to lose them in their pockets or in the bureau drawer. This surgical implanted device bypasses the nerve endings to stimulate directly the auditory nerve fibers to give hearing. It comes with a charging stand that acts as a convenient holder to let you connect to external sound sources. Following the completion of medical treatment for causes of the conductive hearing loss, hearing aids are effective in correcting the remaining hearing loss.
The neural or retrocochlear component can be the result of severe damage to the organ of Corti that causes the nerves of hearing to degenerate or it can be an inability of the hearing nerves themselves to convey neuro chemical information through the central auditory pathways. Once any medically treatable conditions have been ruled out, individuals with a sensorineural hearing loss can be fit with hearing aids to give them access to speech and other important sounds. It’s mostly permanent because sensorineural hearing loss’ is very hard to be cured by medicals or surgery. There is a large literature about genetic causes, mainly in Wolfram's syndrome ( diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), probably because it is relatively easier to publish articles about genetic problems. He defined LTSNH as that the sum of the three low frequencies (125, 250, 500) was more than 100 dB, and the sum of the 3 high frequencies (2, 4, 8) was less than 60 dB. In other words, Wolfram's is probably not diagnosed mainly by ENT's or audiologists, but rather by renal medicine doctors, as DI is exceedingly rare, while LTSNHL is not so rare in hearing tests.
That being said, it is very rare to encounter any substantial change in hearing after pregnancy. The movement of the TM is transferred into a chain of three very small bones in the Middle Ear. Otosclerosis is a largely hereditary condition that occurs more commonly in women and can be connected to pregnancy or menopause.


However, if unrecognized and left untreated, some conductive losses can become extremely serious with permanent impairment to hearing and possibly life-threatening complications. The cochlea is a fluid-filled long tube that is curled like the shell of a snail and lined with thousands of specialized hair cells called cilia. This exposure can be sudden and traumatic, or it can be cumulative over-time and equally damaging to hearing.
Hearing loss involves not only the reception of sound but also our brain’s ability to understand speech. There is no reason to continue to suffer the effects of hearing loss and its degradation to one?s quality of life. Your (otologist) physician’s job is to try to establish the cause of your sensorineural hearing loss which then determines its treatment.
Very mild hearing loss may be best managed with Assistive Listening Devices (ALD) and strategic optimization of the listening environment when possible. Roughly speaking, the frequency patterns of hearing loss are divided up into: Low-frequency, mid-frequency, high-frequency, notches, and flat. To understand what causes hearing loss, it is important to appreciate the different types of hearing loss and how they correspond to the physical components of the ear. The bones work on a lever principle, amplifying the energy as it passes to the Inner Ear at the end of the chain.
When the stirrup bone of the Middle Ear moves, it sends a hydraulic wave through the cochlea. Common sources of excessive noise are industrial noise, work-related noise, military service, music, road noise, guns and hunting, or lawn equipment. Over time, if one has a SNHL and it remains untreated without custom-programmed hearing instruments, the brain loses its ability to discriminate speech. At the very least, have a clinician perform an evaluation to establish a base-line for future comparison.
If the hearing aids are adjustable with hand controls, it may take a few weeks until sufficient dexterity and familiarity with these controls are achieved.
Also it’s known that some drugs are making toxic effect and creating sensorineural hearing loss.
There are lots of researches why depression is causing hearing impairment and it’s known that depression in every age may cause hearing loss.
Anything that impedes the reception, flow, or transfer of energy in the Outer or Middle Ear is known as a Conductive Hearing Loss (CHL). This wave is picked up by the cilia and transposed into electrical impulses sent to the brain.
Once a noise-induced hearing loss begins, we often become even more susceptible to further noise-induced damage.
Of course, similar to eyesight, many adults develop a level of hearing loss simply due to natural aging called Presbycusis. Living troubles on understanding what people say in standard sound is the most known symptom. There is a connection between auditory deprivation and the onset of Alzheimer’s disease.
Also listening TV on higher than normal volume continuously and depression based hearing loss are the main symptoms of hearing impartibility. A cochlear implant attempts to replace the function of the cilia and is only considered in truly profound cases of SNHL. Some deep head traumas may cause sensorineural hearing loss and also rarely but aging may cause it. Advances in hearing aid technology and cochlear implants are helping to improve communication for people affected by hearing loss.
You will be asked about other medical conditions and about what over-the-counter and prescription medications you take.
You may be asked to cover one ear at a time while listening to sounds at different volumes. Tests using a tuning fork can check if there is damage to the parts of the middle ear and eardrum that vibrate.
However, the doctor will try to identify the cause of your hearing loss before treatment can begin.



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