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Neurosensorineural Hearing Loss: A Complex Web of Auditory Challenges

 Neurosensorineural hearing loss, often referred to as sensorineural hearing loss or simply sensory hearing loss, encompasses a range of hearing impairments resulting from damage to the auditory perception apparatus. This condition is notably prevalent 

In the auditory system, two distinct segments can be identified: the sound-conducting and sound-perceiving components. The sound-conducting section serves to transmit sound vibrations to the receptor and includes:


Outer ear

Middle ear

The sound-perceiving section, on the other hand, is responsible for the nervous tissue's response to auditory stimuli and encompasses:


Inner ear

Auditory nerve

Subcortical centers and conducting pathways

Auditory cortex of the brain

Neurosensorineural hearing loss arises due to disruptions in the sound-perceiving section. If hearing impairment results from issues in the sound-conducting segment, it is termed conductive hearing loss. When disruptions affect both segments, it is referred to as mixed hearing loss.


It's important to note that neurosensorineural hearing loss isn't a standalone medical condition but rather a collective term encompassing various nosological forms. The underlying causes can vary significantly, but the hallmark symptom remains the same—diminished hearing. Different regions and scientific communities may employ diverse terminology to describe this condition, including sensorineural hearing loss, neurosensorineural hearing loss, perceptual hearing loss, cochlear neuritis, or cochlear neuropathy. All these names are relevant, as each one encapsulates the concept of hearing impairment at distinct levels of the human auditory system. In Russia, it is commonly referred to as "Sensorineural Hearing Loss."


In the International Classification of Diseases 10th Revision (ICD-10), it is designated as "Neurosensorineural Hearing Loss." According to the Clinical Recommendations developed by the National Medical Association of Otorhinolaryngologists of the Ministry of Healthcare of the Russian Federation in 2016: "Sensorineural hearing loss (neurosensorineural hearing loss, perceptual hearing loss, cochlear neuropathy) is a form of hearing reduction (up to complete loss) where damage can occur in various segments of the auditory analyzer, starting from the immediate sensory apparatus of the cochlea and extending to impairments in neural structures" 


Primarily, it is essential to establish that hearing loss signifies a decrease in the sensitivity of tonal hearing and reduced speech discrimination. Tonal hearing sensitivity, or the hearing threshold, refers to an individual's ability to perceive the quietest sound of a specific frequency (tone) during tonal audiometry.


 

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