of brain tumours can cause hearing loss by infringement of the tumour on the vestibulocochlear nerve viral diseases of the ear can cause sensorineural hearing loss usually as the consequence of labyrinthitis. the person may be generally unwell at the time. measles may cause auditory nerve damage but usually gives rise to a chronic middle ear problem giving rise to mixed hearing loss. mumps (epidemic parotitis) may result in profound sensorineural hearing loss (90 db or more), unilateral (one ear) or bilateral (both ears). congenital rubella (also called german measles) syndrome, can cause deafness in newborns several varieties of herpes viruses that cause other diseases can also infect the ear, and can result in hearing loss: congenital infection with cytomegalovirus is responsible for deafness in newborn children and also progressive sensorineural hearing loss in childhood; herpes simplex type 1, oral herpes associated with cold sores; epstein barr virus that causes mononucleosis; varicella zoster oticus that causes facial paralysis (ramsay hunt syndrome) people with hiv/aids may develop hearing problems due to the disease itself, medications they take for the disease, or an increased rate of other infections. west nile fever, which can cause a variety of neurological disorders, can also cause hearing loss by attacking the auditory nerve. chemicals main article: ototoxicity in addition to medications, hearing loss can also result from specific chemicals in the environment: metals, such as lead; solvents, such as toluene (found in crude oil, gasoline, and automobile exhaust, for example); and asphyxiants. combined with noise, these ototoxic chemicals have an additive effect on a person's hearing loss. hearing loss due to chemicals starts in the high-frequency range and is irreversible. it damages the cochlea with lesions and degrades central portions of the auditory system. for some ototoxic chemical exposures, particularly styrene, the risk of hearing loss can be higher than being exposed to noise alone. the effects are greatest when the combined exposure includes impulse noise. solvents toluene, styrene, xylene, n-hexane, ethyl benzene, white spirits/stoddard, carbon disulfide, jet fuel, perchloroethylene, trichloroethylene, p-xylene asphyxiants carbon monoxide, hydrogen cyanide heavy metals lead, mercury, cadmium, arsenic, tin-hydrocarbon compounds (trimethyltin) pesticides and herbicides – the evidence is weak regarding the association between herbicides and hearing loss; hearing loss in such circumstances may be due to concomitant exposure to insecticides. paraquat, organophosphates a 2018 informational bulletin by the us occupational safety and health administration (osha) and the national institute for occupational safety and health (niosh) introduces the issue, provides examples of ototoxic chemicals, lists the industries and occupations at risk and provides prevention information. medications some medications may reversibly affect hearing. these medications are considered ototoxic. this includes loop diuretics such as furosemide and bumetanide, non-steroidal anti-inflammatory drugs (nsaids) both over-the-counter (aspirin, ibuprofen, naproxen) as well as prescription (celecoxib, diclofenac, etc.), paracetamol, quinine, and macrolide antibiotics. the link between nsaids and hearing loss tends to be greater in women, especially those who take ibuprofen six or more times a week. others may cause permanent hearing loss. the most important group is the aminoglycosides (main member gentamicin) and platinum based chemotherapeutics such as cisplatin and carboplatin. in 2007, the u.s. food and drug administration (fda) warned about possible sudden hearing loss from pde5 inhibitors, which are used for erectile dysfunction. audiologic monitoring for ototoxicity allows for the early detection of changes to hearing status presumably attributed to a drug/treatment regime so that changes in the drug regimen may be considered, and audiologic intervention when handicapping hearing impairment has occurred. co-administration of anti-oxidants and ototoxic medications may limit the extent of the ototoxic damage. physical trauma there can be damage either to the ear, whether the external or middle ear, to the cochlea, or to the brain centres that process the aural information conveyed by the ears. damage to the middle ear may include fracture and discontinuity of the ossicular chain. damage to the inner ear (cochlea) may be caused by temporal bone fracture. people who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent.