SNHL is at least partially preventable by avoiding environmental noise, ototoxic chemicals and drugs, and head trauma, and treating or inoculating against certain triggering diseases and conditions like meningitis. Signs and symptoms
Since the inner ear is not directly accessible to instruments, identification is by patient report of the symptoms and audiometric testing. Of those who present to their doctor with sensorineural hearing loss, 90% report having diminished hearing, 57% report having a plugged feeling in ear, and 49% report having ringing in ear (tinnitus). About half report vestibular (vertigo) problems. For a detailed exposition of symptoms useful for screening, a self-assessment questionnaire was developed by the American Academy of Otolaryngology, called the Hearing Handicap Inventory for Adults (HHIA). It is a 25-question survey of subjective symptoms. Causes
Sensorineural hearing loss may be genetic or acquired (i.e. as a consequence of disease, noise, trauma, etc.). People may have a hearing loss from birth (congenital) or the hearing loss may come on later. Many cases are related to old age (age-related). Genetic
Hearing loss can be inherited. More than 40 genes have been implicated in the cause of deafness. There are 300 syndromes with related hearing loss, and each syndrome may have causative genes. Recessive, dominant, X-linked, or mitochondrial genetic mutations can affect the structure or metabolism of the inner ear. Some may be single point mutations, whereas others are due to chromosomal abnormalities. Some genetic causes give rise to a late onset hearing loss. Mitochondrial mutations can cause SNHL i.e.
Coffee ground vomitus refers to a particular appearance of vomit. Within organic heme molecules of red blood cells is the element iron, which oxidizes following exposure to gastric acid. This reaction causes the vomitus to look like ground coffee. Coffee ground vomitus is a sign of possible upper gastrointestinal bleeding but studies show that it may not require urgent endoscopy. Causes
Esophagitis, esophageal varices, gastritis, cirrhosis or gastric ulcers for example, may bleed and produce coffee-ground vomitus. When unaccompanied by melena, hematemesis or a fall in hemoglobin with corresponding urea rises and creates an unstable reaction, and other causes of coffee ground vomitus need to be elucidated; for example, gastric stasis, bowel obstruction or ileus, that can cause oxidised food material to be vomited. Vomiting iron supplements can also mimic coffee grounds to the untrained eye.Diseases such as Ebola, yellow fever, viral hepatitis, haemophilia B, fatty liver disease and cancers of stomach, pancreas, esophagus and, rarely, retrograde jejunogastric intussusception might also be the reason behind coffee-ground vomitus.When attributed to peptic inflammation, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective serotonin reuptake inhibitors (SSRIs) are commonly implicated. These drugs can interfere with the stomachs natural defenses against the strongly acidic environment, causing damage to the mucosa that can result in bleeding. Therefore, it is recommended that these class of drugs be taken with food or on a full stomach. Other causes of inflammation may be due to severe gastroesophageal reflux disease, Helicobacter pylori gastritis, portal hypertensive gastropathy or malignancy.