Common causes of sensorineural hearing loss include advancing age, Meniere disease, head trauma, noise exposure, ototoxic medications, tumors, or infection. Complications of systemic conditions, such as diabetes, autoimmune disorders, or barotrauma, may also cause sensorineural hearing loss.
Sensorineural hearing loss can present at birth or progress through early childhood and can include genetic causes (ie, Waardenburg syndrome, Usher syndrome, Pendred syndrome), congenital malformations, perilymph fistulas, infection, or prematurity. Causes of congenital hearing loss are almost always sensorineural.
A limited number of cases of sudden sensorineural hearing loss have been documented in relation to COVID-19 as well as with the Pfizer-BioNTech, Moderna, and AstraZeneca vaccinations. These studies suffer from limitations, including recall bias, nocebo effect, and survey methodology. Therefore, more evidence will be needed to determine causality.
Related topics: conductive hearing loss, sudden sensorineural hearing loss
H90.5 – Unspecified sensorineural hearing loss
60700002 – Sensorineural hearing loss
Differential Diagnosis & Pitfalls
- Presbycusis (age related) – most common cause; progressive, bilateral, symmetrical, irreversible sensorineural deafness, often at high frequencies
- Meniere disease – episodic vertigo, ear fullness, tinnitus, commonly lower frequency hearing loss
- Noise-induced hearing loss – high-frequency hearing loss that may present gradually with repeated occupational exposure or suddenly with a short blast of loud noise
- Infection – most commonly viral cochleitis in adults and meningitis in children
- Ototoxic drugs – review medication list for aminoglycosides, loop diuretics, and chemotherapy agents
- Tumors – tinnitus and vertigo that is usually unilateral, except in the case of neurofibromatosis type 2
- Cerebrovascular ischemia
- Congenital – can be bilateral (infection, hereditary) or unilateral (infection, hereditary, malformations, acquired)
- Idiopathic – unilateral, sudden onset
- Complication of another disease – can occur with diabetes, hypothyroidism, or autoimmune disorders
Drug Reaction Data