Which is most likely to cause sensorineural hearing loss?

Sensorineural hearing loss is primarily caused by damage to the inner ear or the auditory nerve pathways that connect the inner ear to the brain. Among the options presented, Meniere's disease is most closely linked to sensorineural hearing loss. This is a disorder characterized by episodes of vertigo, tinnitus (ringing in the ears), aural fullness, and fluctuating hearing loss. The underlying issue in Meniere's disease is often an abnormal accumulation of fluid in the inner ear, which can lead to damage of the hair cells within the cochlea that are responsible for converting sound vibrations into neural signals. This damage can result in permanent sensorineural hearing impairment.

Other options such as a foreign object and impacted cerumen typically cause conductive hearing loss, which means the issue lies in the outer or middle ear preventing sound from being conducted properly to the inner ear. Similarly, serous otitis media (a build-up of fluid in the middle ear space) affects sound transmission but does not directly impact the inner ear structures. Therefore, Meniere's disease is the only condition listed that is associated with direct damage to the auditory structures necessary for sensorineural hearing.