This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Hearing Loss, Subject name: ENT
[{'content': 'All are causes of sensorineural deafness except: \nSelect and explain. \nA. Old age, B. Cochlear otosclerosis, C. Loud sound, D. Rupture of tympanic membrane', 'role': 'user'}, {'content': 'Answer: D \nExplanation: (d) Rupture of tympanic membrane (leads to conductive deafness).(Ref. Cummings, 6th ed., 2201)Old age (presbycusis) leads to SN hearing loss.Loud noise induced hearing loss is associated with pathological changes in cochlea leading to SN hearing loss. Noise trauma, presbycusis and ototoxic drugs involve basal turns of cochlea first; thereby affect high frequency sounds early.Cochlear otosclerosis leads to sensory hearing loss.', 'role': 'assistant'}]