Hearing Loss (Hypacusis): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Alport syndrome (also called progressive hereditary nephritis) – genetic disorder with both autosomal dominant and autosomal recessive inheritance with malformed collagen fibers that can lead to nephritis (inflammation of the kidneys), sensorineural hearing loss, and various eye disorders such as a cataract
  • Alström syndrome – genetic disease with autosomal recessive inheritance; characteristic leading symptoms: retinal degeneration, truncal obesity, diabetes mellitus and sensorineural hearing loss; develop photophobia and nystagmus (uncontrollable, rhythmic movements of the eyes) in early childhood; visual impairment is progressive and the children usually go blind by the age of 12 years; cognitive performance is not or only very slightly impaired
  • Inherited dominant hearing loss/deafness.
  • Inherited mitochondrial hearing loss
  • Inherited sporadic hearing loss/deafness
  • Inherited X-linked hearing loss
  • Usher syndrome – genetic disease with autosomal recessive inheritance; hearing visual impairment characterized by a combination of hearing impairment (early-onset sensorineural hearing loss) or deafness from birth with visual impairment in the form of retinopathy pigmentosa (death of photoreceptors); most common cause of blind deafness.
  • Waardenburg-Klein syndrome – genetic disease, inherited through a recessive sex-linked gene (characteristic symptoms: partial albinism, congenital deafness, etc.).

Certain conditions originating in the perinatal period (P00-P96).

  • Embryopathia rubeolosa – disease of the child due to rubella infection of the mother during pregnancy.
  • Erythroblastosis fetalis – excessive blood formation in the newborn.
  • Mechanical birth defects
  • Perinatal hypoxia – lack of oxygen to the child during birth.

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Diabetes mellitus
  • Gestational diabetes (pregnancy diabetes) (high frequency hearing loss).
  • Hypothyroidism (hypothyroidism).
  • Pendred syndrome – genetic disease with autosomal recessive inheritance, which leads to hypothyroidism (hypothyroidism) with struma formation; in addition, a sensorineural hearing loss, a hypoplasia of the cochlea (cochlea) occurs; in early childhood is often still euthyroidism (normal thyroid function).

Infectious and parasitic diseases (A00-B99).

  • Cytomegaly – viral infection that mainly affects young children.
  • Connatal syphilis (lues) – sexually-transmitted infectious disease transmitted from mother to unborn child during pregnancy.
  • Morbilli (measles)
  • Meningitis (meningitis)
  • Parotitis epidemica (mumps)
  • Syphilis (Lues) – sexually transmitted infectious disease.
  • Toxoplasmosis – common infectious disease of humans and in other mammals, transmitted by the parasite Toxoplasma gondii, which is transmitted mainly through raw meat or cat feces.

Musculoskeletal system and connective tissue (M00-M99).

  • Paget’s disease (stiffening of the ossicles, overgrowth of the cochlea, or crushing of the auditory nerve).

Neoplasms – tumor diseases (C00-D48).

  • Acoustic neuroma (AKN) – benign tumor arising from the Schwanńs cells of the vestibular portion of the VIII. Cranial nerve, the auditory and vestibular nerves (vestibulocochlear nerve), and is located in the cerebellopontine angle or in the internal auditory canal. Acoustic neuroma is the most common cerebellopontine angle tumor. More than 95% of all AKNs are unilateral. In contrast, in the presence of neurofibromatosis type 2, acoustic neuroma typically occurs bilaterally.
  • Tumors of the middle ear

Ears – mastoid process (H60-H95)

  • Cerumen obturans – obstruction of the ear canal by earwax (cerumen).
  • Cholesteatoma (synonym: pearl tumor) of the ear – ingrowth of multilayered keratinizing squamous epithelium in the middle ear with subsequent chronic purulent inflammation of the middle ear.
  • Chronic tubal middle ear catarrh – mucosal inflammation in the area of the middle ear and the tube (connection between the middle ear and the nasopharynx).
  • Chronic noise trauma
  • Cogan syndrome – disease that likely has an autoimmune process as its basis, leading to keratitis (corneal inflammation) and sensorineural hearing loss
  • Deformities of the ear
  • Foreign body in the ear canal
  • Hearing loss
  • Labyrinthitis – inflammation of a structure of the inner ear called the labyrinth.
  • Meniere’s disease – inner ear disease that causes acute attacks of dizziness, ringing in the ears and hearing loss.
  • Otitis media (inflammation of the middle ear)
  • Otosclerosis – bony remodeling of the middle or inner ear with progressive hearing loss.
  • Tympanic effusion (synonym: seromucotympanum) – accumulation of fluid in the middle ear (tympanum).
  • Presbycusis (age-related hearing loss)
  • Tympanic membrane injuries

Psyche – nervous system (F00-F99; G00-G99)

  • Acoustic neuroma, viral
  • Maternal alcohol abuse (alcohol dependence).
  • Refsum syndrome – genetic metabolic disorder that leads primarily to progressive hearing loss from the second decade of life.

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Caisson’s disease – decompression sickness that occurs primarily after surfacing too quickly from great depths.
  • Explosion trauma
  • Fracture (fracture of bone) of the manubrium mallei (malleus peduncle) caused by digital manipulation in the meatus acusticus externus/external auditory canal (conductive hearing loss)
  • Blunt head trauma

Medication

  • See “Causes” under medications