It is different from sensori-neural hearing impairment in that there is no problem with the functioning of the inner ear but the conduction of sound from the environment to the inner ear is impaired due to the presence of fluid in the middle ear. When the loss occurs during or after birth, it is usually related to jaundice, low oxygen levels during birth, meningitis, or trauma to the head. Repeated infections that are not properly treated can also lead to loss of hearing.

If loud environmental noises damage or destroy these hair cells, they do not grow back. This involves the piercing of the eardrum to allow the fluids to drain. During the test, earphones are placed over the ears and various sounds are directed into the ears. The constant ringing, buzzing, swooshing or other unique noises with no outside cause or source is what is referred to as serenity prime and more commonly called "ringing in the ear".

An audiologist can test hearing to determine whether sensorineural serenity prime has developed. There are many reasons for this but today the cost of effective hearing aids is cheaper in real terms than at any time in our history. Children 3 and up can receive services through the public school systems. serenity prime can be so gradual, that many people are unaware they are losing their ability to hear. Otitis media is prevalent in children because of how the inner ear is laid out in kids vs. adults.

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