Unilateral Sensorineural Hearing Loss in Adults: Etiology and Management

Abstract

Unilateral sensorineural hearing loss (SNHL) affects people at any age, can present as an acute and/or progressive process, and can range from mild to profound. Although the great majority of cases have an unknown cause, the known causes of unilateral SNHL need to be excluded including neoplasms, stroke, demyelinating and autoimmune diseases, infection, perilymphatic fistula, and Ménière's disease. The majority of individuals with idiopathic sudden SNHL will recover complete or partial hearing. However, there is a small subset of patients who remain with unilateral hearing impairment, which can result in communication difficulties. The goal of this article is to present the etiology and medical management of unilateral SNHL in the adult population.KEYWORDS: Baha (bone-anchored hearing aid), CROS (contralateral routing of the signal), single-sided deafness, unilateral sensorineural hearing loss Learning Outcomes: As a result of this activity, the participant will be able to (1) list possible etiologies of unilateral sensorineural hearing loss (SNHL) in adults, and (2) list management options for adults with unilateral SNHL.

Subjective and Objective Outcomes from New BiCROS Technology in a Veteran Sample

“…Due to inconsistencies in terminology and methodological differences across studies, the prevalence of SSD within the adult population is difficult to determine, but is considered to be relatively infrequent. SSD can result from numerous etiologies, including sudden idiopathic insult, neoplasms, demyelination, vertebrobasilar stroke, trauma, ototoxicity, infection, Meniere's disease, and autoimmune disease (Voelker and Chole, 2010). Regardless of the etiology, nonmedically treatable SSD can negatively impact functioning in daily life by eliminating the advantages associated with binaural hearing.…”

Sudden Sensorineural Hearing Loss and Delayed Complete Sudden Spontaneous Recovery

“…The sudden loss also could be resultant of cochlear trauma either via acoustic trauma, head injury, ototoxic drugs, or perilymphatic fistula. Other known causes of SSNHL include viral labyrinthitis, Ménière's disease, and autoimmune disease (Voelker and Chole, 2010). If all of these known causes of SSNHL are ruled out in the assessment of a patient with SSNHL, then SSNHL is interpreted as idiopathic.…”

“…These theories include viral infection causing cochlear inflammation, vascular occlusion, membrane rupture, immunologic pathology, and activation of cellular stress pathways (van Dishoeck and Bierman, 1957;Vasama and Linthicum, 2000;Merchant et al, 2005). Support for a viral mechanism involved in idiopathic SSNHL includes that (1) nearly a third of patients with SSNHL report having had a viral-like upper respiratory infection within 1 mo of the onset of the hearing loss, (2) patients with idiopathic SSNHL had higher viral titers for the herpes family, and (3) histopathological evidence in the cochlea was found to be consistent with viral infection (Voelker and Chole, 2010). Both the vascular occlusion and the membrane rupture theories are not supported by histopathological evidence (Vasama and Linthicum, 2000;Merchant et al, 2005).…”

The Early Intervention of Hearing Loss in Adults

“…19 Although the etiologies of these hearing losses are often not known, neoplasms, strokes, autoimmune disorders, infections, and Meniere's disease need to be ruled out, particularly if losses are sudden onset, or rapidly progressing, or complicated with the presence of other symptoms. 20 Indeed, adults with complicated slight-tomild SNHL do often present with other auditory symptoms, some of which require immediate medical attention. Other patients may have clinically significant tinnitus that may be more disabling than their loss of hearing sensitivity.…”