What are the causes of sensorineural hearing loss (SNHL) without trauma?

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Last updated: April 23, 2025View editorial policy

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Differential Diagnosis for Hearing Loss without Trauma

  • Single most likely diagnosis
    • Presbycusis: This is the most common cause of hearing loss in adults, especially those over 65 years old. It is a gradual, age-related decline in hearing ability, particularly affecting high-frequency sounds.
  • Other Likely diagnoses
    • Otosclerosis: A condition where abnormal bone growth in the middle ear causes hearing loss, often affecting young adults.
    • Meniere's disease: A disorder of the inner ear that affects balance and hearing, causing vertigo, tinnitus, and progressive hearing loss.
    • Noise-induced hearing loss: Prolonged exposure to loud sounds can damage the hair cells in the inner ear, leading to hearing loss.
    • Middle ear infections: Recurrent or chronic infections can cause hearing loss due to fluid buildup or damage to the middle ear structures.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Acoustic neuroma: A rare, benign tumor on the nerve connecting the inner ear to the brain, which can cause hearing loss, tinnitus, and balance problems. If left untreated, it can lead to serious complications.
    • Stroke or cerebrovascular accident: Hearing loss can be a symptom of a stroke, particularly if it affects the brainstem or auditory pathways.
    • Multiple sclerosis: An autoimmune disease that can cause hearing loss, among other symptoms, due to damage to the central nervous system.
    • Ototoxicity: Certain medications, such as antibiotics or chemotherapy, can damage the inner ear and cause hearing loss.
  • Rare diagnoses
    • Usher syndrome: A genetic disorder that causes progressive hearing loss and vision loss.
    • Pendred syndrome: A genetic disorder that causes hearing loss and thyroid problems.
    • Autoimmune inner ear disease: A rare condition where the immune system attacks the inner ear, causing hearing loss and vertigo.
    • Cochlear otosclerosis: A rare condition where abnormal bone growth in the inner ear causes hearing loss.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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