Nearly 10% of the adult population has some hearing loss; up to one-third of individuals over the age of 65 have hearing loss of sufficient magnitude to require a hearing aid. Hearing loss can result from disorders of the auricle, external auditory canal, middle ear, inner ear, or central auditory pathways. In general, lesions in the auricle, external auditory canal, or middle ear cause conductive hearing losses, while lesions in the inner ear or eighth nerve cause sensorineural hearing losses.

Figure 61-4
An algorithm for the approach to hearing loss. HL, hearing loss; SNHL, sensorineural hearing loss; TM, tympanic membrane; SOM, serous otitis media; AOM, acute otitis media; *, CT scan of temporal bone; †, MRI scan. (From AK Lalwani, in HPIM-17, p. 201.)