Retrocochlear Disorder
A retrocochlear disorder is a condition affecting the auditory pathway beyond the cochlea, most commonly the auditory nerve or auditory brainstem. The word "retrocochlear" means "behind the cochlea." While most hearing loss originates in the outer, middle, or inner ear, retrocochlear disorders involve structures in the central nervous system or peripheral neural pathways beyond the sensory organ itself.
The most well-known retrocochlear condition is vestibular schwannoma (sometimes called acoustic neuroma), a benign tumor that grows on the vestibular branch of the eighth cranial nerve and can compress the auditory nerve, causing unilateral hearing loss, tinnitus, and balance problems. Other causes include multiple sclerosis, auditory neuropathy, and other neurological conditions. Audiologists screen for retrocochlear disorders when test results show asymmetric hearing loss, poor speech recognition scores that are disproportionate to the degree of hearing loss, or abnormal acoustic reflexes.
Diagnosis typically requires ABR testing and MRI imaging, with findings managed by a neurologist or ENT specialist.
