the middle ear. From the middle ear, a drug can diffuse across the round window membrane into the inner ear. Intratympanic administration of steroids may be effective for sudden sensorineural hearing loss for some patients, but high quality clinical data has not been generated. Intratympanic administration of an anti-apoptotic peptide (JNK inhibitor) is currently being evaluated in late-stage clinical development. Epidemiology General hearing loss affects close to 10% of the global population. In the United States alone, it is expected that 13.5 million Americans have sensorineural hearing loss. Of those with sensorineural hearing loss, approximately 50% are congenitally related. The other 50% are due to maternal or fetal infections, post-natal infections, viral infections due to rubella or cytomegalovirus, ototoxic drugs, exposure to loud sounds, severe head trauma, and premature births Of the genetically related sensorineural hearing loss cases, 75% are autosomal recessive, 15-20% autosomal dominant, and 1-3% sex-linked. While the specific gene and protein is still unknown, mutations in the connexin 26 gene near the DFNB1 locus of chromosome 13 are thought to account for most of the autosomal recessive genetic-related sensorineural hearing loss At least 8.5 per 1000 children younger than age 18 have sensorineural hearing loss. General hearing loss is proportionally related to age. At least 314 per 1000 people older than age 65 have hearing loss. Several risk factors for sensorineural hearing loss have been studied over the past decade. Osteoporosis, stapedectomy surgery, pneumococcal vaccinations, mobile phone users, and hyperbilirubinemia at birth are among some of the known risk factors. See also Conductive hearing loss, hearing loss caused primarily by conditions in the middle ear Cortical deafness, another kind of nerve deafness Hearing loss Inner ear, the innermost portion of the ear containing the sensorineural apparatus of hearing Otosclerosis, a sometimes associated or predecessor conductive hearing loss condition of the middle ear Tinnitus, ringing in the ears, a common accompaniment of SNHL Notes References 38.Ghazavi H,Kargoshaei A-A,Jamshidi-Koohsari M,"Investigation of vitamin D levels in patients with Sudden Sensory-Neural Hearing Loss and its effect on treatment",American journal of otolaryngology and head and neck medicine and suegery,November 2019 https://doi.org/10.1016/j.amjoto.2019.102327 External links Hearing Loss Web Hearing loss Audiology Otology