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.