Abstract
The prevalence and severity of sensorineural hearing loss increase with age, starting in the fourth decade. Age-related hearing loss may result from damage to multiple structures in the auditory system. The typical high-frequency pure-tone threshold elevation may result from damage to the cochlear outer hair cells, caused by lifelong exposure to noise and/or ototoxic substances. High-frequency loss may also result from a decrease in the endocochlear potential, unrelated to noise exposure. Neural degeneration may occur independently or with cochlear damage. The perceptual consequences vary; however, a common report is preserved speech understanding in quiet, but difficulty understanding speech in noise.
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