Children's Hospital Colorado
Ear, Nose and Throat

Sensorineural Hearing Loss in Children

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What is vestibular dysfunction?

Vestibular dysfunction is a vestibular disorder (a disorder relating to the inner ear and balance) that causes loss of balance and dizziness. The vestibular organs are located in the inner ears, next to the hearing organs. These organs sense movement in all directions and relay this information to the brain.

What is sensorineural hearing loss?

Sensorineural hearing loss (SNHL), or sensorineural deafness, is permanent hearing loss that can range from mild to total loss of hearing.

What causes vestibular dysfunction?

Vestibular dysfunction happens when there is damage to the vestibular system. We commonly see vestibular dysfunction in people with sensorineural hearing loss because the cause of their hearing loss may also cause damage to the vestibular organs. Vestibular dysfunction can also occur because of infection, head injury or exposure to certain medications that are ototoxic (toxic to the ear).

What causes sensorineural hearing loss?

Damage to the hearing organs in the inner ears, or to the nerves that attach the inner ears to the brain, can cause sensorineural hearing loss. Hearing loss can be the result of a congenital condition, meaning it’s present at birth, or it can be acquired by damage to the hair cells (small sensory receptor cells in the inner ear) or by damage to the auditory nerve.

Common causes of damage to the hearing hair cells that can lead to hearing loss include:

  • Head injury
  • Loud noises, such as an explosion or gunshot
  • Exposure to ototoxic medications
  • Medical conditions, either acquired or congenital

Some causes of permanent hearing loss are more likely to lead to vestibular dysfunction than others. Infections, disorders, tumors and treatments that can cause hearing loss and vestibular dysfunction include:

  • Viral infections such as measles, meningitis, mumps and labyrinthitis
  • Autoimmune disorders such as lupus and thyroiditis
  • Tumors such as acoustic neuroma
  • Congenital conditions such as cytomegalovirus (cCMV), enlarged vestibular aqueduct (EVA) and inner ear or 8th nerve malformations
  • Genetic syndromes such as Usher’s, Waardenburg, Pendred, CHARGE and Alport
  • Ototoxic medications including chemotherapy
  • Cochlear implants

Who gets vestibular dysfunction?

Children with permanent hearing loss, including SNHL, commonly have balance problems — up to 70% of children with permanent hearing loss also have loss of vestibular function leading to balance problems. Children with higher levels of hearing loss are more likely to have vestibular problems.

What does the vestibular system do?

The vestibular organs are located inside the inner ears, next to the hearing organs. They sense movement and tell the brain where the person is in space. The central vestibular system in the brain gathers this information and tells the eyes and body to make changes to keep the person upright.

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