Audiological and radiological diagnosis of sensorineural hearing loss in Africa

Abstract

Abstract Background Sensorineural hearing loss (SNHL) poses a significant public health burden globally, with a disproportionately higher prevalence in developing regions like Africa. The consequences of SNHL in early childhood can be devastating, impacting speech, language, cognitive, and psychosocial development, ultimately affecting educational attainment and quality of life. The etiology of SNHL is multifactorial, encompassing genetic predispositions, prenatal and perinatal complications, infections, ototoxic insults, and environmental factors. In the African context, preventable causes such as congenital rubella, meningitis, mumps, and ototoxic medications play a significant role. Additionally, the high prevalence of consanguineous marriages and the lack of universal newborn hearing screening programs contribute to delayed diagnosis and interventions. Early and accurate diagnosis of SNHL is crucial for timely and appropriate medical, surgical, or audiological (re)habilitative measures. Main body However, the diagnosis of SNHL, particularly in children, can be challenging, necessitating a combination of audiological and radiological evaluations. Audiological assessments; behavioral measures (pure-tone audiometry [PTA]), electroacoustic measures (immittance audiometry and otoacoustic emissions), and electrophysiologic measures (auditory brainstem response and auditory steady-state response) are comprehensive audiological assessments which remain the cornerstone for identifying the site, degree, and laterality of hearing loss. They cannot localize or detect the underlying pathology, and this may affect the determination of appropriate interventions such as hearing aids, cochlear implants, other amplification devices, and other management options. Radiological imaging techniques, particularly computed tomography and magnetic resonance imaging, have revolutionized the evaluation of SNHL by providing detailed visualization of the intricate anatomy and pathologies of the bony and membranous labyrinths, respectively. Conclusion SNHL poses a significant challenge in the African context, with a higher burden and unique etiological patterns. Early and accurate diagnosis, facilitated by the integration of audiological and radiological evaluations, is crucial for timely interventions and optimal outcomes.