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Sensorineural and Noise-Induced hearing Loss
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Sensorineural hearing loss (SNHL), commonly known as “nerve loss” or “nerve damage”, is hearing loss usually caused by loss of hair cells, the special cells that convert sound energy into signals sent to the brain in the cochlea (inner ear). A better name for this type of hearing loss would be “cochlear hair cell loss”. All humans are born with several thousand hair cells in each cochlea.

There are many things which can cause loss of these hair cells, including acoustic trauma (noise damage), the aging process, genetics/hereditary factors, Meniere’s disease, viral infections, certain medications, head trauma, tumors (especially vestibular schwannoma), and unknown factors.  Once hair cells are damaged or lost for whatever reason, they are not replaced and do not regenerate, and the hearing loss is generally permanent.  In SNHL, the outer and middle ear structures, including the ear drum and ossicles (tiny middle ear bones) are working normally and transferring sound energy into the inner ear, but the inner ear is not able to convert some or all this energy into signals to the brain due to loss of hair cells.  SNHL may range from mild hearing loss, which may be barely noticeable, to profound SNHL, which is total deafness.  Patients with this degree of SNHL may be candidates for cochlear implantation.   


Evaluation and Treatment for SNHL

If you have hearing loss, it is recommended that you visit an ear specialist like Dr. Paul Shea at the Shea Clinic, who will perform a thorough exam and evaluation on you and will order tests to determine the exact nature and cause of your hearing loss.  SNHL may occur by itself, or may be part of another condition, like Meniere’s disease or tinnitus, which may need further investigation and treatment.  SNHL should be distinguished from conductive hearing loss, which is hearing loss caused by something interfering with transmission of sound from the outside world to the inner ear, because this type of hearing loss is treated differently, and can possibly be improved with a surgical procedure.  If you have SNHL in one or both ears, then a hearing aid may be appropriate, and Dr. Shea will discuss this with you. 


What is Noise-Induced Hearing Loss (NIHL)?

Did you know that external sounds from traffic or the radio can adversely affect your ear health?  With over 30 million U.S citizens being exposed to hazardous noise levels on their job, noise-induced hearing loss has become a growing concern.  It is now the second most common type of hearing loss for Americans and warrants a closer look.  NIHL is the result of unmonitored, loud sounds from the environment. These hazardous levels of sound produce vibrations in the inner ear that can permanently damage hearing.  This condition affects individuals of all ages. A study conducted by the CDC in 2017 suggested that at least 10 million adults (6%) in the U.S. under age 70, and perhaps as many as 40 million adults (24%), have signs on their hearing tests that suggests hearing loss from exposure to loud noise in one or both ears. 


Causes of Noise-Induced Hearing Loss 

NIHL can be the result of continuous exposure to loud sounds over extended intervals of time or a single one-time exposure to an intensely loud sound, such as a gunshot.  Sound levels under 70 decibels are unlikely to cause hearing loss.  The risk of hearing loss increases with levels above 85 decibels. The louder the sound and the longer the duration of exposure, the higher the risk of NIHL. 


Symptoms of Ear Damage from Loud Noise

Ear damage from loud noise is easily identifiable. Although damage from unmonitored exposure to noise is usually a gradual process, the symptoms of hearing loss are usually quite evident.  They include distortion or muffling of sounds over time. Additionally, one’s ability to understand or hear during conversation might be hindered. Patients affected with NIHL are more likely to turn up the volume of their televisions and other audio devices.  Additionally, NIHL affects the ability to hear, communicate and participate in social situations.  Many patients with NIHL will also have tinnitus (ringing in their ears) which may or may not be a problem for them.   


Noise-Induced Hearing Loss Treatment

Although there isn’t an established clinical treatment for NIHL, curbing the exposure to loud noises by using ear plugs or earmuffs is the primary strategy to combat the problem. The good news is that NIHL is the only type of hearing loss that is 100% preventable. The key to preventing NIHL is knowing which sounds are potentially hazardous and to wear earplugs or protective equipment to protect your hearing. Be alert of your environment and most importantly, don’t underestimate the harmful effect of loud noise on your ears.


Prevention is Better Than Cure

When in doubt, always visit your ENT physician. The Shea Clinic can help provide you with the answers you need and recommend the best course of treatment for your NIHL.  


Cross Section Diagram Through the Cochlea


When you lose your hearing, those around you suffer the most.

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