Retrocochlear Hearing Loss

This topic provides information about retrocochlear hearing loss. Be sure to check our general page on all types of hearing loss if you are looking for more information.

What is retrocochlear hearing loss?

Retrocochlear hearing loss is a term used to describe a neural or central hearing loss which occurs beyond the cochlea, affecting the vestibulocochlear nerve (auditory nerve) or central auditory system.

What causes retrocochlear hearing loss?

Although retrocochlear hearing disorders are rare, there are a variety of locations and causes of retrocochlear hearing loss. Some of these may include:

• Infections
• Metabolic Disorders
• Demyelinating Disease such as multiple sclerosis
• Vascular disorders
• Head trauma affecting the temporal lobe
• Aging or dementia
• Tumors of the acoustic nerve or central auditory cortex
• Auditory neuropathy
• Ototoxic medications (drugs that are toxic to the ears)

What are the symptoms?

Symptoms of retrocochlear hearing loss usually involves only one ear, including:

• Unilateral or asymmetric tinnitus
• Unilateral or asymmetric hearing loss
• Vertigo or dizziness
• Unilateral fullness of the ear
• Facial weakness or paralysis
• Poor speech discrimination regardless of hearing level

How is retrocochlear hearing loss diagnosed?

In most cases, it is not possible to distinguish between a sensory impairment (involving the cochlea), and a retrocochlear pathology.

If a retrocochlear pathology is suspected, a comprehensive audiologic evaluation should be performed, to include acoustic reflex testing, otoacoustic emissions (OAE), and an auditory brainstem response (ABR) test. Depending on the results of these audiologic tests, further testing may be recommended. The gold standard for diagnosing an auditory tumor (acoustic neuroma) is the MRI.

How is it treated?

Treatment will vary greatly depending on the pathology causing the retrocochlear hearing loss. Surgical intervention may be necessary for removal of an acoustic neuroma.

Depending on the degree of hearing loss, a retrocochlear hearing loss may be effectively managed with the use of hearing aids or other hearing technology.