Diseases » Sensorineural deafness » Causes

Causes of Sensorineural deafness

Causes of Sensorineural deafness (Diseases Database):

The follow list shows some of the possible medical causes of Sensorineural deafness that are listed by the Diseases Database:

• Galactose epimerase deficiency
• Black locks, oculocutaneous albinism, and deafness of the sensorineural type
• Meningoencephalitis
• Keutel syndrome
• Barakat syndrome
• Ramsay Hunt syndrome
• Loken Senior syndrome
• BRESHECK syndrome
• Streptomycin
• Glomus jugulare tumor
• Alström syndrome
• Capreomycin sulfate
• Multiple sclerosis
• Amikacin
• Kanamycin
• Lassa fever
• Etacrynic acid
• MELAS
• Marshall syndrome
• Keratitis-ichthyosis-deafness syndrome, autosomal recessive
• Vogt-Koyanagi-Harada syndrome
• Townes-Brocks syndrome
• Susac's syndrome
• Wildervanck's syndrome
• Muckle-Wells syndrome
• Bart-Pumphrey syndrome
• MERRF
• Generalized gangliosidosis GM1
• Epstein's macrothrombocytopenia syndrome
• Gentamicin
• Frusemide
• Okihiro syndrome
• Cerebral palsy
• Myhre syndrome
• Alpha-L-iduronidase deficiency
• Recessive deafness-onychodystrophy-osteodystrophy-retardation syndrome
• Amphotericin B
• Rubella, congenital
• Nance perilymphatic gusher-deafness syndrome
• Meniere disease
• Acoustic neuroma
• Down syndrome
• Rubella
• Pendred's syndrome
• Bumetanide
• X-linked mental retardation-hypotonic facies syndrome
• Paget's disease of bone
• Noise-induced hearing loss
• Vancomycin
• Thiamine-responsive megaloblastic anemia syndrome
• Hereditary sensory and autonomic neuropathy type 1
• Tietz hypopigmentation-deafness syndrome
• Enlarged vestibular aqueduct syndrome
• Spondyloepiphyseal dysplasia congenita
• Cholesteatoma
• Intracranial space-occupying lesion
• Netilmicin
• Bartter's syndrome
• Oculovestibuloauditory syndrome
• Hystrix-like ichthyosis with deafness
• Craniofacial-deafness-hand syndrome
• Cockayne syndrome
• Radiotherapy
• Bjornstad syndrome
• Familial Danish dementia
• Melnick-Fraser syndrome
• Jones syndrome
• Kernicterus
• Donnai-Barrow syndrome
• Osteopathia striata with cranial sclerosis
• Osteopetrosis (malignant)
• Aspirin
• Usher's syndrome
• Presbyacusis
• Lenz-Majewski hyperostosis syndrome
• Cytomegalovirus, congenital
• Refsum's disease
• Syphilis, congenital
• Neurofibromatosis type 2
• Otodental dysplasia
• Yemenite deaf-blind hypopigmentation syndrome
• Cisplatin
• Stickler syndrome
• Brown-Vialetto-van Laere syndrome
• Lange Nielsen syndrome
• Waardenburg syndrome type 1
• Fechtner syndrome
• Diabetes-deafness syndrome maternally transmitted
• Autosomal recessive nonsyndromic deafness type 1
• DOOR syndrome (autosomal dominant)
• DIDMOAD syndrome
• Mohr-Tranebjaerg syndrome
• Alport's syndrome
• Desferrioxamine
• Harboyan syndrome
• Faisalabad histiocytosis
• Jensen syndrome

Source: Diseases Database

Sensorineural deafness Causes: Book Excerpts

• Differential Diagnosis - Hearing Loss
• Differential Diagnosis - Hearing Loss – Acquired
• Differential Diagnosis - Hearing Loss – Congenital
• Medical causes - Hearing loss
• Causes and incidence - Hearing loss
• Medical causes - Hearing loss
• Differential Overview - Hearing Loss
• Causes - Hearing loss
• Medical causes - Hearing loss
• Principal Causes of Hearing Loss and Deafness - Hearing Loss and Deafness
• Medical causes - Hearing loss

Sensorineural deafness as a complication of other conditions:

Other conditions that might have Sensorineural deafness as a complication may, potentially, be an underlying cause of Sensorineural deafness. Our database lists the following as having Sensorineural deafness as a complication of that condition:

• Juvenile Paget disease
• Lassa fever
• Paget disease juvenile type

Sensorineural deafness as a symptom:

Conditions listing Sensorineural deafness as a symptom may also be potential underlying causes of Sensorineural deafness. Our database lists the following as having Sensorineural deafness as a symptom of that condition:

• Alpha-mannosidosis type II
• Arthritis - short stature - deafness
• Athabaskan brainstem dysgenesis
• Athabaskan severe combined immunodeficiency
• Atherosclerosis, premature - deafness - diabetes mellitus - photomyoclonus - nephropathy - degenerative neurologic disease
• Atherosclerosis- deafness - diabetes - epilepsy - nephropathy
• Bosley-Salih-Alorainy syndrome
• Cataract deafness hypogonadism
• Cerebral dysgenesis, neuropathy, ichthyosis, and palmoplantar keratoderma syndrome
• CHARGE Syndrome
• Chromosome 3, monosomy 3p25
• Coenzyme Q 10 (CoQ10), deficiency
• Corneal dystrophy and perceptive deafness
• De Sanctis-Cacchione syndrome
• Deafness - onychodystrophy - osteodystrophy - mental retardation
• Deafness - skeletal dysplasia - lip granuloma
• Deafness neurosensory - pituitary dwarfism
• Deafness peripheral - neuropathy - arterial disease
• Deafness, autosomal dominant nonsyndromic sensorineural 1
• Deafness, autosomal dominant nonsyndromic sensorineural 10
• Deafness, autosomal dominant nonsyndromic sensorineural 11
• Deafness, autosomal dominant nonsyndromic sensorineural 12
• Deafness, autosomal dominant nonsyndromic sensorineural 13
• Deafness, autosomal dominant nonsyndromic sensorineural 15
• Deafness, autosomal dominant nonsyndromic sensorineural 18
• Deafness, autosomal dominant nonsyndromic sensorineural 2
• Deafness, autosomal dominant nonsyndromic sensorineural 21
• Deafness, autosomal dominant nonsyndromic sensorineural 25
• Deafness, autosomal dominant nonsyndromic sensorineural 28
• Deafness, autosomal dominant nonsyndromic sensorineural 3
• Deafness, autosomal dominant nonsyndromic sensorineural 30
• Deafness, autosomal dominant nonsyndromic sensorineural 31
• Deafness, autosomal dominant nonsyndromic sensorineural 36
• Deafness, autosomal dominant nonsyndromic sensorineural 4
• Deafness, autosomal dominant nonsyndromic sensorineural 41
• Deafness, autosomal dominant nonsyndromic sensorineural 43
• Deafness, autosomal dominant nonsyndromic sensorineural 44
• Deafness, autosomal dominant nonsyndromic sensorineural 47
• Deafness, autosomal dominant nonsyndromic sensorineural 48
• Deafness, autosomal dominant nonsyndromic sensorineural 49
• Deafness, autosomal dominant nonsyndromic sensorineural 5
• Deafness, autosomal dominant nonsyndromic sensorineural 53
• Deafness, autosomal dominant nonsyndromic sensorineural 6
• Deafness, autosomal dominant nonsyndromic sensorineural 7
• Deafness, autosomal dominant nonsyndromic sensorineural 8
• Deafness, autosomal dominant nonsyndromic sensorineural 9
• Deafness, congenital onychodystrophy, recessive form
• Del(1) (pter-p36.2)
• Feigenbaum-Bergeron-Richardson syndrome
• FG syndrome 1
• FG syndrome 2
• FG syndrome 3
• FG syndrome 4
• FG syndrome 5
• Galactosemia III
• Growth delay due to insulin-like growth factor I deficiency
• Human HOXA1 Syndromes
• Ichthyosiform Erythroderma, Corneal Involvement and Deafness Syndrome
• Ichthyosiform erythroderma, corneal involvement, deafness
• Iris dysplasia with ocular hypertelorism, psychomotor retardation and sensorineural deafness
• Johanson-Blizzard Syndrome
• Juvenile-onset dystonia
• Keratitis Ichthyosis Deafness Syndrome
• Leiomyomatosis of oesophagus, congenital cataract and hematuria
• LEOPARD Syndrome
• Marshall syndrome
• Molarization of anterior teeth deafness
• Neuroectodermal endocrine syndrome
• Neurosyphilis - general paresis
• Neurosyphilis - meningovascular
• Neurosyphilis - tabes dorsalis
• Neutropenia - monocytopenia - deafness
• Onychodystrophy - deafness
• Osteochondrodysplatic dwarfism - deafness - retinitis pigmentosa
• Otodental dysplasia
• Phosphoribosylpyrophosphate synthetase superactivity
• Schaap-Taylor-Baraitser syndrome
• Senter syndrome
• Short stature deafness neutrophil dysfunction
• Spinocerebellar ataxia, X-linked, 3
• Stickler Syndrome
• Stickler Syndrome, type I
• Stickler Syndrome, type II
• Stickler Syndrome, type III
• Susac syndrome
• Temtamy preaxial brachydactyly syndrome
• Thyrocerebral-retinal syndrome
• Tunglang-Savage-Bellman syndrome

Related information on causes of Sensorineural deafness:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Sensorineural deafness may be found in:

• Hidden causes of Sensorineural deafness

Causes of Sensorineural deafness: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Sensorineural deafness.

Hearing Loss: Differential Diagnosis
(In a Page: Signs and Symptoms)

Conductive hearing loss: Results from any process preventing sound from reaching the inner ear
–Obstruction of the ear canal, usually due to cerumen impaction or foreign body
–Otitis media with middle ear effusion (most common in children but also occurs in adults)
–Chronic otitis media: Permanent change in the ear (e.g., tympanic membrane perforation, ossicular chain discontinuity and fixation, cholesteatoma) secondary to otitis media
–Congenital atresia of the external auditory canal

• Sensorineural hearing loss: Nerve type hearing loss, either in the inner ear or the auditory nerve
  –Presbycusis is the most common form
  –Noise-induced hearing (occupational or nonoccupational)
  –Hereditary sensorineural hearing loss, usually autosomal recessive heritance
  –Medications (e.g., aminoglycosides, chemotherapeutics, diuretics)
  –Ménie're's disease: Hearing loss, tinnitus, vertigo, and aural fullness
  –Acoustic neuroma: Results in unilateral hearing loss and tinnitus as the initial symptoms in 90% of patients
  –Alport's syndrome: Hereditary nephritis, sensorineural deafness, ocular abnormalities)
• Mixed hearing loss (both conductive and sensorineural hearing loss)
  –Wardenberg's syndrome
  –Prolonged QT syndrome variant
  –Other causes of congenital deafness
  –Meningitis
  –Vascular (e.g., embolism, thrombosis, hemorrhage)
  –Viral (e.g., mumps, measles, influenza, varicella, adenovirus, EBV)

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Hearing Loss – Acquired: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

Conductive (CHL)

• Cerumen impaction
• External auditory canal foreign body
• Middle ear effusion (MEE)
  –Frequently follows acute otitis media
• Tympanic membrane (TM) perforation
  –Usually due to trauma, chronic otitis media
• Cholesteatoma
  –Acquired cholesteatoma is accompanied by TM retraction or perforation
  –Congenital cholesteatoma is usually over an intact TM
• Ossicular erosion or fixation due to middle ear disease
• Ossicular chain discontinuity (generally posttraumatic)
• External auditory canal stenosis from chronic otitis externa
• Middle ear tumor
  –Paraganglioma (glomus tympanicum), facial neuroma, histiocytosis X, etc.

Sensorineural (SNHL)
• Meningitis, especially bacterial
• Viral, especially mumps
• Autoimmune disease
  –Vasculitis, scleroderma, Kawasaki disease
  –Idiopathic
• Acoustic trauma (noise-induced)
• Ototoxic medications
  –Aminoglycosides
  –Diuretics (especially loop diuretics)
  –Salicylates
  –Cytotoxic (chemotherapeutic) agents, e.g., cisplatinum
• Temporal bone fracture
  –SNHL more likely with transverse than longitudinal fracture
• Perilymphatic fistula (PLF)
  –Hearing loss may be progressive or fluctuating
  • Cerebellopontine angle (CPA) tumor
    –Vestibular schwannoma (a.k.a. acoustic neuroma, associated with type II neurofibromatosis), meningioma, etc.
    –SNHL will be unilateral
  • Ménière disease
    –Characterized by hearing loss, vertigo, tinnitus, sensation of aural fullness

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Hearing Loss – Congenital: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

• Infections
  –CMV: Most common intrauterine infection causing hearing loss
  –Bacterial meningitis
  –Congenital rubella: Cataracts, cardiovascular anomalies, retinitis, mental retardation
  –Congenital syphilis
  –Toxoplasmosis
  –Lyme disease
• Metabolic
  –Hyperbilirubinemia (kernicterus): Consider phototherapy or exchange transfusion if serum bilirubin >20 mg/dL in newborn
  –Hypercholesterolemia

• Ototoxic medications
  –Aminoglycoside, gentamicin often needed for perinatal sepsis; >5 days risks hearing loss
• Temporal bone anomaly
  –Middle ear anomaly (results in conductive hearing loss)
  –Perilymphatic fistula
  –Dilated vestibular aqueduct (±Mondini deformity)
  –Michel cochlear aplasia
  –Scheibe aplasia: Membranous aplasia; bony labyrinth normal
  • Nonsyndromic hereditary congenital deafness (connexin 26 gene mutation is responsible for half of all genetic deafness)
  • Syndromic hereditary congenital deafness
    –Waardenburg: Telecanthus, confluent eyebrow, colored irides, white forlock
    –Usher: Retinitis pigmentosa (totally blind by second to third decade), ataxia, vestibular dysfunction
    –Alport: Progressive nephritis and hearing loss
    –Apert (acrocephalosyndactyly): Craniofacial dysostosis
    –Crouzon (craniofacial dysostosis): Prognathic mandibile, small maxilla
    –Jervell and Lange-Neilsen: Heart disease (prolonged QT interval)
    –Pendred: Euthyroid goiter
    –Oto-palatal-digital: Cleft palate, stubby clubbed digits
    –Congential aural atresia

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Hearing loss: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Acoustic neuroma

Acoustic neuroma, which is a CN VIII tumor, causes unilateral, progressive, sensorineural hearing loss The patient may also develop tinnitus, vertigo, and — with cranial nerve compression — facial paralysis.

Adenoid hypertrophy

Eustachian tube dysfunction causes gradual conductive hearing loss accompanied by intermittent ear discharge The patient also tends to breathe through his mouth and may complain of a sensation of ear fullness.

Aural polyps

If a polyp occludes the external auditory canal, partial hearing loss may occur The polyp typically bleeds easily and is covered by a purulent discharge.

Cholesteatoma

Gradual hearing loss is characteristic It can be accompanied by vertigo and, at times, facial paralysis

Examination reveals eardrum perforation, pearly white balls in the ear canal, and possible discharge.

Cyst

Ear canal obstruction by a sebaceous or dermoid cyst causes progressive conductive hearing loss On inspection, the cyst looks like a soft mass.

External ear canal tumor (malignant)

Progressive conductive hearing loss is characteristic and is accompanied by deep, boring ear pain, purulent discharge and, eventually, facial paralysis Examination may detect the granular, bleeding tumor.

Glomus jugulare tumor

Initially, this benign tumor causes mild, unilateral conductive hearing loss that becomes progressively more severe The patient may report tinnitus that sounds like his heartbeat

Associated signs and symptoms include gradual congestion in the affected ear, throbbing or pulsating discomfort, bloody otorrhea, facial nerve paralysis, and vertigo. Although the tympanic membrane is normal, a reddened mass appears behind it.

Head trauma

Sudden conductive or sensorineural hearing loss may result from ossicle disruption, ear canal fracture, tympanic membrane perforation, or cochlear fracture associated with head trauma Typically, the patient reports a headache and exhibits bleeding from his ear

Neurologic features vary and may include impaired vision and an altered level of consciousness.

Ménière’s disease

Initially, Ménière’s disease, an inner ear disorder, produces intermittent, unilateral sensorineural hearing loss that involves only low tones Later, hearing loss becomes constant and affects other tones

Associated signs and symptoms include intermittent severe vertigo, nausea and vomiting, a feeling of fullness in the ear, a roaring or hollow-seashell tinnitus, diaphoresis, and nystagmus.

Nasopharyngeal cancer

Nasopharyngeal cancer causes mild unilateral conductive hearing loss when it compresses the eustachian tube

Bone conduction is normal, and inspection reveals a retracted tympanic membrane backed by fluid. When this tumor obstructs the nasal airway, the patient may exhibit nasal speech and a bloody nasal and postnasal discharge. Cranial nerve involvement produces other findings, such as diplopia and rectus muscle paralysis.

Otitis externa

Conductive hearing loss resulting from debris in the ear canal characterizes acute and malignant otitis externa With acute otitis externa, ear canal inflammation produces pain, itching, and a foul-smelling, sticky yellow discharge

Severe tenderness is typically elicited by chewing, opening the mouth, and pressing on the tragus or mastoid. The patient may also develop a low-grade fever, regional lymphadenopathy, a headache on the affected side, and mild to moderate pain around the ear that may later intensify. Examination may reveal greenish white debris or edema in the canal.

With malignant otitis externa, debris is also visible in the canal. This life-threatening disorder, which most commonly occurs in the patient with diabetes, causes sensorineural hearing loss, pruritus, tinnitus, and severe ear pain.

Otitis media

Otitis media is a middle ear inflammation that typically produces unilateral conductive hearing loss In patients with acute suppurative otitis media, the hearing loss develops gradually over a few hours and is usually accompanied by an upper respiratory tract infection with a sore throat, cough, nasal discharge, and headache. Related signs and symptoms include dizziness, a sensation of fullness in the ear, intermittent or constant ear pain, a fever, nausea, and vomiting. Rupture of the bulging, swollen tympanic membrane relieves the pain and produces a brief, bloody, purulent discharge. Hearing returns after the infection subsides.

Hearing loss also develops gradually in patients with chronic otitis media. Assessment may reveal a perforated tympanic membrane, purulent ear drainage, an earache, nausea, and vertigo.

Commonly associated with an upper respiratory tract infection or nasopharyngeal cancer, serous otitis media commonly produces a stuffy feeling in the ear and pain that worsens at night. Examination reveals a retracted — and perhaps discolored — tympanic membrane and possibly air bubbles behind the membrane.

Otosclerosis

Otosclerosis is a hereditary disorder in which unilateral conductive hearing loss usually begins when the patient is in his early twenties and may gradually progress to bilateral mixed loss The patient may report tinnitus and an ability to hear better in a noisy environment

The deafness is usually noticed between ages 11 and 30.

Gender cue

Otosclerosis affects twice as many women as men, and the condition may worsen during pregnancy.

Skull fracture

Auditory nerve injury causes sudden unilateral sensorineural hearing loss Accompanying signs and symptoms include ringing tinnitus, blood behind the tympanic membrane, scalp wounds, and other findings.

Temporal bone fracture

Temporal bone fracture can cause sudden unilateral sensorineural hearing loss accompanied by hissing tinnitus The tympanic membrane may be perforated, depending on the fracture’s location

Loss of consciousness, Battle’s sign, and facial paralysis may also occur.

Tympanic membrane perforation

Commonly caused by trauma from sharp objects or rapid pressure changes, perforation of the tympanic membrane causes abrupt hearing loss along with ear pain, tinnitus, vertigo, and a sensation of fullness in the ear.

Other causes

Drugs

Ototoxic drugs typically produce ringing or buzzing tinnitus and a feeling of fullness in the ear Chloroquine, cisplatin, vancomycin, and aminoglycosides (especially neomycin, kanamycin, and amikacin) may cause irreversible hearing loss

Loop diuretics, such as furosemide, ethacrynic acid, and bumetanide, usually produce a brief, reversible hearing loss. Quinine, quinidine, and high doses of erythromycin or salicylates (such as aspirin) may also cause reversible hearing loss.

Radiation therapy

Irradiation of the middle ear, thyroid, face, skull, or nasopharynx may cause eustachian tube dysfunction, resulting in hearing loss

Surgery

Myringotomy, myringoplasty, simple or radical mastoidectomy, or fenestrations may cause scarring that interferes with hearing.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Hearing loss: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

Congenital hearing loss may be transmitted as a dominant, autosomal dominant, autosomal recessive, or sex-linked recessive trait. Hearing loss in neonates may also result from trauma, toxicity, or infection during pregnancy or delivery. Predisposing factors include a family history of hearing loss or known hereditary disorders (otosclerosis, for example), maternal exposure to rubella or syphilis during pregnancy, use of ototoxic drugs during pregnancy, prolonged fetal anoxia during delivery, and congenital abnormalities of the ears, nose, or throat. Premature or low-birth-weight neonates are most likely to have structural or functional hearing impairment; those with serum bilirubin levels above 20 mg/dl also risk hearing impairment from the toxic effect of high serum bilirubin levels on the brain. In addition, trauma during delivery may cause intracranial hemorrhage and may damage the cochlea or the acoustic nerve.

Sudden deafness refers to sudden hearing loss in a person with no prior hearing impairment. This condition is considered a medical emergency because prompt treatment may restore full hearing. Its causes and predisposing factors may include:

❑ acute infections, especially mumps (most common cause of unilateral sensorineural hearing loss in children), and other bacterial and viral infections, such as rubella, rubeola, influenza, herpes zoster, and infectious mononucleosis; and mycoplasma infections

❑ blood dyscrasias (leukemia, hypercoagulation)

❑ head trauma or brain tumors

❑ metabolic disorders (diabetes mellitus, hypothyroidism, hyperlipoproteinemia)

❑ neurologic disorders (multiple sclerosis, neurosyphilis)

❑ ototoxic drugs (tobramycin, streptomycin, quinine, gentamicin, furosemide, ethacrynic acid)

❑ vascular disorders (hypertension, arteriosclerosis).

Noise-induced hearing loss, which may be transient or permanent, may follow prolonged exposure to loud noise (85 to 90 dB) or brief exposure to extremely loud noise (greater than 90 dB). Such hearing loss is common in workers subjected to constant industrial noise and in military personnel, hunters, and rock musicians.

Presbycusis, an otologic effect of aging, results from a loss of hair cells in the organ of Corti. This disorder causes progressive, symmetrical, bilateral sensorineural hearing loss, usually of high-frequency tones.

Minor decreases in hearing are common after age 20. Some deafness due to nerve damage occurs in one of every five people by age 55.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Hearing loss: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Acoustic neuroma

This eighth cranial nerve tumor causes unilateral, progressive, sensorineural hearing loss. The patient may also develop tinnitus, vertigo, and—with cranial nerve compression—facial paralysis.

Adenoid hypertrophy

Eustachian tube dysfunction gradually causes conductive hearing loss accompanied by intermittent ear discharge. The patient also tends to breathe through his mouth and may complain of a sensation of ear fullness.

Allergies

Conductive hearing loss may result when an allergy produces eustachian tube and middle ear congestion. Other features include ear pain or a feeling of fullness, nasal congestion, and conjunctivitis.

Aural polyps

If a polyp occludes the external auditory canal, partial hearing loss may occur. The polyp typically bleeds easily and is covered by a purulent discharge.

Cholesteatoma

Gradual hearing loss is characteristic in this disorder and may be accompanied by vertigo and, at times, facial paralysis. Examination reveals eardrum perforation, pearly white balls in the ear canal and, possibly, a discharge.

Cyst

Ear canal obstruction by a sebaceous or dermoid cyst causes progressive conductive hearing loss. On inspection, the cyst looks like a soft mass.

External ear canal tumor (malignant)

Progressive conductive hearing loss is characteristic and is accompanied by deep, boring ear pain; a purulent discharge; and eventually facial paralysis. Examination may detect the granular, bleeding tumor.

Furuncle

Reversible conductive hearing loss may occur when one of these painful, hard nodules forms in the ear. The patient may report a sense of fullness in the ear and pain on palpation of the tragus or auricle. Rupture relieves the pain and produces a purulent, necrotic discharge.

Glomus jugulare tumor

Initially, this benign tumor causes mild, unilateral conductive hearing loss that becomes progressively more severe. The patient may report tinnitus that sounds like his heartbeat. Associated signs and symptoms include gradual congestion in the affected ear, throbbing or pulsating discomfort, bloody otorrhea, facial nerve paralysis, and vertigo. Although the tympanic membrane is normal, a reddened mass appears behind it.

Glomus tympanum tumor

This cancerous middle ear tumor causes slowly progressive hearing loss and throbbing or pulsating tinnitus. It usually bleeds easily when manipulated. Late features include ear pain, dizziness, and total unilateral deafness.

Granuloma

A rare cause of conductive hearing loss, a granuloma may also produce fullness in the ear, deep-seated pain, and a bloody discharge.

Head trauma

Sudden conductive or sensorineural hearing loss may result from ossicle disruption, ear canal fracture, tympanic membrane perforation, or cochlear fracture associated with head trauma. Typically, the patient reports a headache and exhibits bleeding from his ear. Neurologic features vary and may include impaired vision and altered level of consciousness.

Herpes zoster oticus (Ramsay Hunt syndrome)

This syndrome causes sudden severe, unilateral mixed hearing loss, which may be accompanied by vesicles in the external ear, tinnitus, vertigo, ear pain, malaise, and transient ipsilateral facial paralysis.

Hypothyroidism

This disorder may produce reversible sensorineural hearing loss. Other effects include bradycardia, weight gain despite anorexia, mental dullness, cold intolerance, facial edema, brittle hair, and dry skin that’s pale, cool, and doughy.

Ménière’s disease

Initially, this inner ear disorder produces intermittent, unilateral sensorineural hearing loss that involves only low tones. Later, hearing loss becomes constant and affects other tones. Associated signs and symptoms include intermittent severe vertigo, nausea and vomiting, a feeling of fullness in the ear, a roaring or hollow-seashell tinnitus, diaphoresis, and nystagmus.

Multiple sclerosis

Rarely, this disorder causes sensorineural hearing loss associated with myelin destruction of the central auditory pathways. The hearing loss may be sudden and unilateral or intermittent and bilateral. Among other characteristics are impaired vision, paresthesia, muscle weakness, gait ataxia, intention tremor, urinary disturbances, and emotional lability.

Myringitis

Rarely, acute infectious myringitis produces conductive hearing loss when fluid accumulates in the middle ear or a large bleb totally obstructs the ear canal. Small, reddened inflamed blebs may develop in the canal, on the tympanic membrane, or in the middle ear and may produce a bloody discharge if they rupture. Associated findings may include severe ear pain, mastoid tenderness, and fever.

Chronic granular myringitis produces gradual hearing loss accompanied by pruritus and a purulent discharge.

Nasopharyngeal cancer

This type of cancer causes mild unilateral conductive hearing loss when it compresses the eustachian tube. Bone conduction is normal, and inspection reveals a retracted tympanic membrane backed by fluid. When this tumor obstructs the nasal airway, the patient may exhibit nasal speech and a bloody nasal and postnasal discharge. Cranial nerve involvement produces other findings, such as diplopia and rectus muscle paralysis.

Osteoma

Commonly affecting women and swimmers, osteoma may cause sudden or intermittent conductive hearing loss. Typically, bony projections are visible in the ear canal, but the tympanic membrane appears normal.

Otitis externa

Conductive hearing loss resulting from debris in the ear canal characterizes both acute and malignant otitis externa. In acute otitis externa, ear canal inflammation produces pain, itching, and a foul-smelling, sticky yellow discharge. Severe tenderness is typically elicited by chewing, opening the mouth, and pressing on the tragus or mastoid. The patient may also develop a low-grade fever, regional lymphadenopathy, a headache on the affected side, and mild to moderate pain around the ear that may later intensify. Examination may reveal greenish white debris or edema in the canal.

In malignant otitis externa, debris is also visible in the canal. This life-threatening disorder, which most commonly occurs in diabetics, causes sensorineural hearing loss, pruritus, tinnitus, and severe ear pain.

Otitis media

This middle ear inflammation typically produces unilateral conductive hearing loss. In acute suppurative otitis media, the hearing loss develops gradually over a few hours and is usually accompanied by an upper respiratory tract infection with sore throat, cough, nasal discharge, and headache. Related signs and symptoms include dizziness, a sensation of fullness in the ear, intermittent or constant ear pain, fever, nausea, and vomiting. Rupture of the bulging, swollen tympanic membrane relieves the pain and produces a brief bloody and purulent discharge. Hearing returns after the infection subsides.

Hearing loss also develops gradually in patients with chronic otitis media. Assessment may reveal a perforated tympanic membrane, purulent ear drainage, earache, nausea, and vertigo.

Commonly associated with an upper respiratory tract  infection or nasopharyngeal cancer, serous otitis media commonly produces a stuffy feeling in the ear and pain that worsens at night. Examination reveals a retracted—and perhaps discolored—tympanic membrane and possibly air bubbles behind the membrane.

Otosclerosis

In this hereditary disorder, unilateral conductive hearing loss usually begins when the patient is in his early twenties and may gradually progress to bilateral mixed hearing loss. The patient may report tinnitus and an ability to hear better in a noisy environment.

Gender Cue: Otosclerosis affects twice as many women as men and may worsen during pregnancy.

Skull fracture

Auditory nerve injury causes sudden unilateral sensorineural hearing loss. Accompanying signs and symptoms include ringing tinnitus, blood behind the tympanic membrane, scalp wounds, and other findings.

Syphilis

In tertiary syphilis, sensorineural hearing loss may develop suddenly or gradually and usually affects one ear more than the other. It’s usually accompanied by a gumma lesion—a chronic, superficial nodule or a deep, granulomatous lesion on the skin or mucous membranes. The lesion is solitary, asymmetrical, painless, and indurated. The patient may also exhibit signs of liver, respiratory, cardiovascular, or neurologic dysfunction.

Temporal arteritis

This disorder may produce unilateral sensorineural hearing loss accompanied by throbbing unilateral facial pain, pain behind the eye, temporal or frontotemporal headache, and occasionally vision loss. The hearing loss is usually preceded by a prodrome of malaise, anorexia, weight loss, weakness, and myalgia that lasts for several days. Examination may reveal a nodular, swollen temporal artery. Low-grade fever, confusion, and disorientation may also occur.

Temporal bone fracture

This fracture can cause sudden unilateral sensorineural hearing loss accompanied by hissing tinnitus. The tympanic membrane may be perforated, depending on the fracture’s location. Loss of consciousness, Battle’s sign, and facial paralysis may also occur.

Tuberculosis

This pulmonary infection may spread to the ear, resulting in eardrum perforation, mild conductive hearing loss, and cervical lymphadenopathy.

Tympanic membrane perforation

Commonly caused by trauma from sharp objects or rapid pressure changes, perforation of the tympanic membrane causes abrupt hearing loss along with ear pain, tinnitus, vertigo, and a sensation of fullness in the ear.

Wegener’s granulomatosis

Conductive hearing loss develops slowly in this rare necrotizing, granulomatous vasculitis. This multisystem disorder may also cause cough, pleuritic chest pain, epistaxis, hemorrhagic skin lesions, oliguria, and nasal discharge.

Other causes

Drugs

Ototoxic drugs typically produce ringing or buzzing tinnitus and a feeling of fullness in the ear. Chloroquine, cisplatin, vancomycin, and aminoglycosides (especially neomycin, kanamycin, and amikacin) may cause irreversible hearing loss. Loop diuretics, such as furosemide, ethacrynic acid, and bumetanide, usually produce a brief, reversible hearing loss. Quinine, quinidine, and high doses of erythromycin or salicylates (such as aspirin) may also cause reversible hearing loss.

Radiation therapy

Irradiation of the middle ear, thyroid, face, skull, or nasopharynx may cause eustachian tube dysfunction, resulting in hearing loss.

Surgery

Myringotomy, myringoplasty, simple or radical mastoidectomy, or fenestrations may cause scarring that interferes with hearing.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Hearing Loss: Differential Overview
(Field Guide to Bedside Diagnosis)

Sensorineural

❑ Presbyacusis

❑ Noise-induced loss

❑ Drugs

❑ Ménière disease

❑ Eighth nerve injury

❑ Acoustic neuroma

❑ Multiple sclerosis

Conductive

❑ Impacted cerumen

❑ Otitis media

❑ Middle ear effusion

❑ Perforation of tympanic membrane

❑ Otosclerosis

❑ Exostoses

❑ Developmental defect

❑ Glomus tumor

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Hearing loss: Causes
(Handbook of Diseases)

Hearing loss may be congenital, or it may be caused by drugs, illness, loud noise, or aging.

Congenital hearing loss

Hearing loss may be transmitted as a dominant, autosomal dominant, autosomal recessive, or sex-linked recessive trait. In neonates, it may also result from trauma, toxicity, or infection during pregnancy or delivery.

Predisposing factors include a family history of hearing loss or known hereditary disorders (such as otosclerosis), maternal exposure to rubella or syphilis during pregnancy, use of ototoxic drugs during pregnancy, prolonged fetal anoxia during delivery, and congenital abnormalities of the ears, nose, or throat.

Premature or low-birth-weight infants are most likely to have structural or functional hearing impairments; those with serum bilirubin levels greater than 20 mg/dl also risk hearing impairment from the toxic effect of high serum bilirubin levels on the brain.

In addition, trauma during delivery may cause intracranial hemorrhage and damage the cochlea or acoustic nerve.

Sudden hearing loss

Sudden hearing loss may occur in a person with no prior hearing impairment. This condition is considered a medical emergency because prompt treatment may restore full hearing. Its causes and predisposing factors may include:

❑ acute infections, especially mumps (the most common cause of unilateral sensorineural hearing loss in children) and other bacterial and viral infections, such as rubella, rubeola, influenza, herpes zoster, and infectious mononucleosis, and mycoplasmal infections

❑ metabolic disorders, such as diabetes mellitus, hypothyroidism, and hyperlipoproteinemia

❑ vascular disorders, such as hypertension and arteriosclerosis

❑ head trauma or brain tumors

❑ ototoxic drugs, such as tobramycin, streptomycin, quinine, gentamicin, furosemide, and ethacrynic acid

❑ neurologic disorders, such as multiple sclerosis and neurosyphilis

❑ blood dyscrasias, such as leukemia and hypercoagulation.

Noise-induced hearing loss

Noise-induced hearing loss is caused by a loud noise and may be transient or permanent, and may follow prolonged exposure to loud noise (85 to 90 dB) or brief exposure to extremely loud noise (greater than 90 dB). Such hearing loss is common in workers subjected to constant industrial noise and in military personnel, hunters, and rock musicians.

Presbycusis

An otologic effect of aging, presbycusis results from a loss of hair cells in the organ of Corti. This disorder causes sensorineural hearing loss, usually of high-frequency tones.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Hearing loss: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Acoustic neuroma

An acoustic neuroma is an eighth cranial nerve tumor that causes unilateral, progressive, sensorineural hearing loss. The patient may also develop tinnitus, vertigo and, with cranial nerve compression, facial paralysis.

Adenoid hypertrophy

With adenoid hypertrophy, eustachian tube dysfunction gradually causes conductive hearing loss accompanied by intermittent ear discharge. The patient also tends to breathe through his mouth and may complain of a sensation of ear fullness.

Allergies

Conductive hearing loss may result when an allergy produces eustachian tube and middle ear congestion. Other features include ear pain or a feeling of fullness, nasal congestion, and conjunctivitis.

Cholesteatoma

Gradual hearing loss is characteristic in cholesteatoma. It can be accompanied by vertigo and, at times, facial paralysis. Examination reveals eardrum perforation, pearly white balls in the ear canal and, possibly, a discharge.

External ear canal tumor (malignant)

Progressive conductive hearing loss is characteristic of a malignant external ear canal tumor and is accompanied by deep, boring ear pain; purulent discharge; and eventually facial paralysis. Examination may detect the granular, bleeding tumor.

Furuncle

Reversible conductive hearing loss may occur when a furuncle (a painful, hard nodule) forms in the ear. The patient with a furuncle may report a sense of fullness in the ear and pain on palpation of the tragus or auricle. Boil rupture relieves the pain and produces a purulent, necrotic discharge.

Glomus jugulare tumor

Initially, glomus jugulare (a benign tumor) causes mild, unilateral conductive hearing loss that becomes progressively more severe. The patient may report tinnitus that sounds like his heartbeat. Associated signs and symptoms include gradual congestion in the affected ear, throbbing or pulsating discomfort, bloody otorrhea, facial nerve paralysis, and vertigo. Although the tympanic membrane is normal, a reddened mass appears behind it.

Head trauma

Sudden conductive or sensorineural hearing loss may result from ossicle disruption, ear canal fracture, tympanic membrane perforation, or cochlear fracture associated with head trauma. Typically, the patient reports a headache and exhibits bleeding from his ear. Neurologic features vary and may include impaired vision and altered level of consciousness.

Hypothyroidism

Hypothyroidism may produce reversible sensorineural hearing loss. Other effects include bradycardia, weight gain despite anorexia, mental dullness, cold intolerance, facial edema, brittle hair, and dry skin that’s pale, cool, and doughy.

Ménière’s disease

Initially, Ménière’s disease produces intermittent, unilateral sensorineural hearing loss that involves only low tones. Later in this inner ear disorder, hearing loss becomes constant and affects other tones. Associated signs and symptoms of Ménière’s disease include intermittent severe vertigo, nausea and vomiting, a feeling of fullness in the ear, a roaring or hollow-seashell tinnitus, diaphoresis, and nystagmus.

Osteoma

Commonly affecting women and swimmers, osteoma may cause sudden or intermittent conductive hearing loss. Typically, bony projections are visible in the ear canal, but the tympanic membrane appears normal.

Otitis externa

Conductive hearing loss resulting from debris in the ear canal characterizes both acute and malignant otitis externa. With acute otitis externa, ear canal inflammation produces pain, itching, and a foul-smelling, sticky yellow discharge. Severe tenderness is typically elicited by chewing, opening the mouth, and pressing on the tragus or mastoid. The patient may also develop a low-grade fever, regional lymphadenopathy, headache on the affected side, and mild-to-moderate pain around the ear that may later intensify. Examination may reveal greenish white debris or edema in the canal.

With malignant otitis externa, debris is also visible in the canal. This life-threatening disorder, which most commonly occurs in diabetics, causes sensorineural hearing loss, pruritus, tinnitus, and severe ear pain.

Otitis media

Otitis media is a middle ear inflammation that typically produces unilateral conductive hearing loss. In patients with acute suppurative otitis media, the hearing loss develops gradually over a few hours and is usually accompanied by an upper respiratory tract infection with sore throat, cough, nasal discharge, and headache. Related signs and symptoms include dizziness, a sensation of fullness in the ear, intermittent or constant ear pain, fever, nausea, and vomiting. Rupture of the bulging, swollen tympanic membrane relieves the pain and produces a brief, bloody, purulent discharge. Hearing returns after the infection subsides.

Hearing loss also develops gradually in patients with chronic otitis media. Assessment may reveal a perforated tympanic membrane, purulent ear drainage, earache, nausea, and vertigo.

Commonly associated with an upper respiratory tract infection or nasopharyngeal cancer, serous otitis media commonly produces a stuffy feeling in the ear and pain that worsens at night. Examination reveals a retracted — and perhaps discolored — tympanic membrane and, possibly, air bubbles behind the membrane.

Otosclerosis

In otosclerosis, a hereditary disorder, unilateral conductive hearing loss usually begins when the patient is in his early 20s and may gradually progress to bilateral mixed loss. The patient may report tinnitus and an ability to hear better in a noisy environment. The deafness is usually noticed between ages 11 and 30.

Skull fracture

Auditory nerve injury from a skull fracture causes sudden unilateral sensorineural hearing loss. Accompanying signs and symptoms include ringing tinnitus, blood behind the tympanic membrane, scalp wounds, and other findings.

Temporal arteritis

Temporal arteritis may produce unilateral sensorineural hearing loss accompanied by throbbing unilateral facial pain, pain behind the eye, temporal or frontotemporal headache and, occasionally, vision loss. The hearing loss is usually preceded by a prodrome of malaise, anorexia, weight loss, weakness, and myalgia that lasts for several days. Examination may reveal a nodular, swollen temporal artery. Low-grade fever, confusion, and disorientation may also occur.

Temporal bone fracture

Temporal bone fracture can cause sudden unilateral sensorineural hearing loss accompanied by hissing tinnitus. The tympanic membrane may be perforated, depending on the fracture’s location. Loss of consciousness, Battle’s sign, and facial paralysis may also occur.

Tuberculosis

Tuberculosis, a pulmonary infection, may spread to the ear, resulting in eardrum perforation, mild conductive hearing loss, and cervical lymphadenopathy. Other signs and symptoms include chest pain, crackles, dyspnea, fatigue, fever, and tachypnea.

Tympanic membrane perforation

Commonly caused by trauma from sharp objects or rapid pressure changes, perforation of the tympanic membrane causes abrupt hearing loss along with ear pain, tinnitus, vertigo, and a sensation of fullness in the ear.

Other causes

Drugs

Ototoxic drugs typically produce ringing or buzzing tinnitus and a feeling of fullness in the ear. Chloroquine, cisplatin, vancomycin, and aminoglycosides (especially neomycin, kanamycin, and amikacin) may cause irreversible hearing loss. Loop diuretics, such as furosemide, ethacrynic acid, and bumetanide, usually produce a brief, reversible hearing loss. Quinine, quinidine, and high doses of erythromycin or salicylates (such as aspirin) may also cause reversible hearing loss.

Radiation therapy

Irradiation of the middle ear, thyroid, face, skull, or nasopharynx may cause eustachian tube dysfunction, resulting in hearing loss.

Surgery

Myringotomy, myringoplasty, simple or radical mastoidectomy, or fenestrations may cause scarring that interferes with hearing.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Hearing Loss and Deafness: Principal Causes of Hearing Loss and Deafness
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

1. Conductivehearing loss
   1. Externalauditory canal disorders
      1. Atresia of external auditory canal
      2. Impacted cerumen
      3. Otitis externa
      4. Exostosis
      5. Masses
   2. Middle ear disorders
      1. Acuteand chronic otitis media
      2. Otitis media with effusion
      3. Tympanic membrane perforation
      4. Hemotympanum
      5. Tympanosclerosis
      6. Ossicular chain defect, disruption,or fixation
      7. Cholesteatoma and other middle earmasses
2. Sensorineural hearing loss
   1. Sensorineuralhearing loss without associated abnormalities
   2. Sensorineural hearing loss with associatedabnormalities
   3. Chromosomal disorders
   4. Inner ear malformations
      1. Labyrinthineaplasia
      2. Common cavity malformation
      3. Cochlear malformations
      4. Large vestibular aqueduct
   5. Prematurity
   6. Hypoxic-ischemic encephalopathy
   7. Bilirubin encephalopathy (kernicterus)
   8. Infection
   9. Trauma
   10. Drugs
   11. Perilymph fistula
   12. Neoplasm
   13. Ménière disease
   14. Unknown
3. Mixed hearing loss

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Hearing loss: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Acoustic neuroma.Acoustic neuroma, which is a CN VIII tumor, causes unilateral, progressive, sensorineural hearing loss. The patient may also develop tinnitus, vertigo, and—with cranial nerve compression—facial paralysis.

Adenoid hypertrophy.Eustachian tube dysfunction causes gradual conductive hearing loss accompanied by intermittent ear discharge. The patient also tends to breathe through his mouth and may complain of a sensation of ear fullness.

Aural polyps.If a polyp occludes the external auditory canal, partial hearing loss may occur. The polyp typically bleeds easily and is covered by a purulent discharge.

Cholesteatoma.Gradual hearing loss is characteristic of cholesteatoma. It can be accompanied by vertigo and, at times, facial paralysis. Examination reveals eardrum perforation, pearly white balls in the ear canal, and possible discharge.

Cyst.Ear canal obstruction by a sebaceous or dermoid cyst causes progressive conductive hearing loss. On inspection, the cyst looks like a soft mass.

External ear canal tumor (malignant).Progressive conductive hearing loss is characteristic of an external ear canal tumor and is accompanied by deep, boring ear pain, purulent discharge and, eventually, facial paralysis. The patient may develop a rash in the external canal or pinna of the ear. Examination may detect the granular, bleeding tumor.

Glomus jugulare tumor.Initially, this benign tumor causes mild, unilateral conductive hearing loss that becomes progressively more severe. The patient may report tinnitus that sounds like his heartbeat. Associated signs and symptoms include gradual congestion in the affected ear, throbbing or pulsating discomfort, bloody otorrhea, facial nerve paralysis, and vertigo. Although the tympanic membrane is normal, a reddened mass appears behind it.

Head trauma.Sudden conductive or sensorineural hearing loss may result from ossicle disruption, ear canal fracture, tympanic membrane perforation, or cochlear fracture associated with head trauma. Typically, the patient reports a headache and exhibits bleeding from his ear. Neurologic features vary and may include impaired vision and an altered level of consciousness.

Ménière's disease.Initially, Ménière's disease, an inner ear disorder, produces intermittent, unilateral sensorineural hearing loss that involves only low tones. Later, hearing loss becomes constant and affects other tones. Associated signs and symptoms include intermittent severe vertigo, nausea and vomiting, a feeling of fullness in the ear, a roaring or hollow-seashell tinnitus, diaphoresis, and nystagmus.

Nasopharyngeal cancer.Nasopharyngeal cancer causes mild unilateral conductive hearing loss when it compresses the eustachian tube. Bone conduction is normal, and inspection reveals a retracted tympanic membrane backed by fluid. When this tumor obstructs the nasal airway, the patient may exhibit nasal speech and a bloody nasal and postnasal discharge. Cranial nerve involvement produces other findings, such as diplopia and rectus muscle paralysis.

Otitis externa.Conductive hearing loss resulting from debris in the ear canal characterizes acute and malignant otitis externa. With acute otitis externa, ear canal inflammation produces pain, itching, and a foul-smelling, sticky yellow discharge. Severe tenderness is typically elicited by chewing, opening the mouth, and pressing on the tragus or mastoid. The patient may also develop a low-grade fever, regional lymphadenopathy, a headache on the affected side, and mild to moderate pain around the ear that may later intensify. Examination may reveal greenish white debris or edema in the canal.

With malignant otitis externa, debris is also visible in the canal. This life-threatening disorder, which most commonly occurs in the patient with diabetes, causes sensorineural hearing loss, pruritus, tinnitus, and severe ear pain.

Otitis media.Otitis media is a middle ear inflammation that typically produces unilateral conductive hearing loss. In patients with acute suppurative otitis media, the hearing loss develops gradually over a few hours and is usually accompanied by an upper respiratory tract infection with a sore throat, cough, nasal discharge, and headache. Related signs and symptoms include dizziness, a sensation of fullness in the ear, intermittent or constant ear pain, a fever, nausea, and vomiting. Rupture of the bulging, swollen tympanic membrane relieves the pain and produces a brief, bloody, purulent discharge. Hearing returns after the infection subsides.

Hearing loss also develops gradually in patients with chronic otitis media. Assessment may reveal a perforated tympanic membrane, purulent ear drainage, an earache, nausea, and vertigo.

Commonly associated with an upper respiratory tract infection or nasopharyngeal cancer, serous otitis media commonly produces a stuffy feeling in the ear and pain that worsens at night. Examination reveals a retracted—and perhaps discolored—tympanic membrane and possibly air bubbles behind the membrane.

Otosclerosis.Otosclerosis is a hereditary disorder in which unilateral conductive hearing loss usually begins when the patient is in his early twenties and may gradually progress to bilateral mixed loss. The patient may report tinnitus and an ability to hear better in a noisy environment. The deafness is usually noticed between ages 11 and 30.

Skull fracture.With a skull fracture, auditory nerve injury causes sudden unilateral sensorineural hearing loss. Accompanying signs and symptoms include ringing tinnitus, blood behind the tympanic membrane, scalp wounds, and other findings.

Temporal bone fracture.Temporal bone fracture can cause sudden unilateral sensorineural hearing loss accompanied by hissing tinnitus. The tympanic membrane may be perforated, depending on the fracture's location. Loss of consciousness, Battle's sign, and facial paralysis may also occur.

Tympanic membrane perforation.Commonly caused by trauma from sharp objects or rapid pressure changes, perforation of the tympanic membrane causes abrupt hearing loss along with ear pain, tinnitus, vertigo, and a sensation of fullness in the ear.

Other causes

Drugs.Ototoxic drugs typically produce ringing or buzzing tinnitus and a feeling of fullness in the ear. Chloroquine, cisplatin, vancomycin, and aminoglycosides (especially neomycin, kanamycin, and amikacin) may cause irreversible hearing loss. Loop diuretics, such as furosemide, ethacrynic acid, and bumetanide, usually produce a brief, reversible hearing loss. Quinine, quinidine, and high doses of erythromycin or salicylates (such as aspirin) may also cause reversible hearing loss.

Radiation therapy.Irradiation of the middle ear, thyroid, face, skull, or nasopharynx may cause eustachian tube dysfunction, resulting in hearing loss.

Surgery.Myringotomy, myringoplasty, simple or radical mastoidectomy, or fenestrations may cause scarring that interferes with hearing.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

 » Next page: Symptoms of Sensorineural deafness

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