Preventing Sensorineural Hearing Loss: A Review of Modifiable Risk Factors, Early Screening, and Neuroprotective Strategies

Sensorineural hearing loss (SNHL) is by far the most prevalent cause of reported hearing loss globally, and is primarily caused by damage to the cochlea, auditory nerve and/or central auditory pathways through various mechanisms. The evidence suggests that the vast majority of the time, these factors are associated with SNHL as a result of modifiable risk factors, including exposure to loud noise, ototoxic chemicals and drugs, certain vascular/metabolic conditions (diabetes), and other health challenges. The result is a major opportunity for developing primary and secondary preventive initiatives. Potential strategies for reducing or eliminating the risk of SNHL include community awareness and health campaigns, community screening programmes to detect early stages of SNHL, measuring risk for those who are at high risk of developing SNHL (by addressing their modifiable risk factors), and by providing early intervention opportunities through the introduction of cochlear implants and/or the application of surgical techniques to protect residual hearing. Somewhat paradoxically, although advances continue to be made towards understanding the impact of modifiable determinants and preventive activities; there still remains a disconnect between the clinical practice and prevention programmes on the population level. Combining epidemiological risk assessment and early intervention through screening, addressing risk factors through lifestyle changes and surgical protection, and enabling prevention policies for modifiable risk factors should be effective in reducing the incidence of, and burden associated with, SNHL. Future research efforts and coordinated public health strategy should and must be encouraged, to make implementable, scalable and evidence-based preventive measures available to the population throughout their lives.