[The type of traumatic sensorineural hearing loss affects diagnostic and medico-legal assessment]

Traumatic sensorineural hearing loss (TSHN) is mostly a high-frequency loss resembling noise-induced hearing loss (NIHL). However, approx. 25% of TSHN audiograms differ from NIHL in being of the slope, flat or low-frequency type. The physical properties of the trauma influence the audiogram shape, and the great individual variation of susceptibility to TSHN indicates the importance of genetic factors as well. As TSHN, like NIHL, predominantly is of a metabolic rather than a mechanical nature, its magnitude and configuration may change considerably during the first weeks after the causative incident.