Hearing loss is a complex health condition, and it’s different for everyone. At the same time, it’s relatively common; approximately 15% of all American adults over age 18 have some trouble with hearing. While everyone experiences hearing loss slightly differently, it can be grouped into three main categories: conductive hearing loss, sensorineural hearing loss and mixed hearing loss.

How We Hear
Before we get into the differences between sensorineural, conductive and mixed hearing loss, let’s review how hearing works. First, a sound wave enters the outer ear and travels down the ear canal, which leads to the eardrum. The sound wave hits the eardrum, which vibrates in response. The eardrum sends these vibrations to three tiny bones in the middle ear. These bones—the malleus, incus and stapes—conduct the vibrations into the inner ear. The inner ear is home to an organ called the cochlea, where tiny sensory cells convert the vibrations into electrical signals, which are then transmitted to the brain.
All three types of hearing loss—sensorineural, conductive and mixed—occur when some part of this process is obstructed or broken down.
Conductive Hearing Loss
Conductive hearing loss occurs due to dysfunction in the outer or middle ear. With this type of hearing loss, sound waves are unable to reach the inner ear. Some common ways this happens are:
- Earwax blockage
- Foreign object lodged in ear canal
- Ruptured eardrum
- Ear infection
- The middle ear is filled with fluid
- Bone abnormality
- Ear tumor
- Trauma or injury
How to Treat Conductive Hearing Loss
Because many factors can cause conductive hearing loss, treatments may vary. In some cases, such as earwax blockage or an ear infection, conductive hearing loss is temporary and resolves when the underlying cause resolves. Other cases may require medical attention, such as surgery.
Sensorineural Hearing Loss
When the hearing process breaks down in the inner ear, that is sensorineural hearing loss. Most commonly, it is caused by the damage or degeneration of the tiny sensory cells in the cochlea. When these cells cease to function, they are unable to convert vibrations to electrical signals and communicate them to the brain. Some things that can cause this to happen are:
- The natural process of aging
- Exposure to loud noise
- Disease
- Ototoxic medications and drugs
- Trauma or injury
- Autoimmune disorders in which the immune system attacks healthy cells in the ear
- High blood pressure
- Diabetes
How to Treat Sensorineural Hearing Loss
Damaged or dead sensory cells do not regenerate, so sensorineural hearing loss is not reversible or treatable with operations or medication. The most effective way to manage sensorineural hearing loss is with hearing aids, which can be programmed to fill in the gaps in your hearing ability. They do this by:
- Amplifying sounds
- Amplifying specific frequencies
- Suppressing background noise
- Digitally process incoming sound waves
Mixed Hearing Loss
Mixed hearing loss is, as the name suggests, a combination of conductive and sensorineural hearing loss. This could happen due to a variety of factors: perhaps a patient has sensorineural hearing loss and then develops conductive hearing loss, or perhaps an ototoxic drug taken to treat a virus causing conductive hearing loss leads to sensorineural hearing loss.
How to Treat Mixed Hearing Loss
Mixed hearing loss is often a combination of causes and factors, and therefore, treatment can vary widely. Consult with your doctor and hearing health specialist about the best treatment options for your mixed hearing loss.
When to See an Audiologist
If you’re experiencing hearing loss, seek help from an audiologist as soon as possible. A hearing test can determine what type of hearing loss you have, which will help you and your audiologist determine the best course of treatment. Call Elevate Audiology today to make an appointment or to learn more.
