Sensorineural hearing losses, also referred to as nerve deafness, usually result from a loss of hair cells in the inner ear. Sound waves are delivered to the inner ear, but due to missing hair cells, impulses are not delivered to the brain and so the sound is not perceived. Individuals with sensorineural hearing loss will hear sound but it may be distorted. Often people with this type loss will say, "I can hear people talking. I just don't understand what they are saying." Hearing aids can help improve understanding of speech for individuals with sensorineural hearing loss. Common causes of sensorineural losses are noise exposure, aging, infection, or genetic defects. Additionally, abnormal fluid pressure in the inner ear can cause a sensorineural hearing loss. Examples include Meniere's disease - too much fluid pressure and perilymph fistula (hole in the cochlea) - too little fluid pressure. Occasionally, a small benign tumor (acoustic neuroma) may be pressing on the auditory nerve causing hearing loss.

Sensorineural hearing loss is the most common type of hearing loss. More than 90 percent of all hearing aid wearers have sensorineural hearing loss. The most common causes of sensorineural hearing loss are age related changes and noise exposure. A sensorineural hearing loss may also result from disturbance of inner ear circulation, increased inner fluid pressure or from disturbances of nerve transmission. Sensorineural hearing loss is also called "cochlear loss," an "inner ear loss" and is also commonly called "nerve loss." Years ago, many professionals said there was nothing that could be done for sensorineural hearing loss – that is totally incorrect today. There are many excellent options for the patient with sensorineural hearing loss.

A person with a sensorineural hearing loss may report that they can hear people talking, but they can’t understand what they are saying. An increase in the loudness of speech may only add to their confusion. This person will usually hear better in quiet places and may have difficulty understanding what is said over the telephone.

Central hearing impairment occurs when auditory centers of the brain are affected by injury, disease, tumor, hereditary, or unknown causes. Loudness of sound is not necessarily affected, although understanding of speech, also thought of as the "clarity" of speech may be affected. Certainly both loudness and clarity may be affected too.