Asymmetrical hearing loss

Background General practitioners are usually the first point of contact for patients with hearing loss. Asymmetrical sensorineural hearing loss can be a symptom of a wide range of diseases. A correct diagnosis is essential for appropriate treatment and limitation of the progression of hearing loss. Objective This article provides an outline for an approach to a patient presenting with asymmetrical sensorineural hearing loss, and also provides a brief summary of four disease processes which may present with asymmetrical hearing loss. Discussion Asymmetrical sensorineural hearing loss may be secondary to the process of aging or simply be related to excessive noise exposure. It can however, be the only presenting symptom of a vestibular schwannoma or an intracranial tumour. A high level of clinical suspicion is required to ensure that these pathologies are not missed.