An older patient is diagnosed with sensorineural hearing loss. You know that causes of sensorineural hearing loss include: (Select all that apply.)

A. Tumors of the middle ear are more likely to cause conductive hearing loss, not sensorineural. B. Cerumen impaction blocks sound conduction in the external auditory canal and is a cause of conductive hearing loss. C. Age-related hearing impairment (presbycusis) is a common cause of sensorineural hearing loss, involving damage to inner ear structures or the auditory nerve. D. Infections of the external and middle ear (such as otitis media or externa) typically result in conductive hearing loss. E. Excessive and loud noise can damage the hair cells in the cochlea, a hallmark of sensorineural hearing loss.