Types of Hearing Loss: A Guide

The Types of Hearing Loss

Medical professionals classify hearing loss by determining which part of your ear is affected. Some hearing experts cite three main types of hearing loss, but others say there are four. According to the Centers for Disease Control, the four types of hearing loss are:

• Conductive hearing loss: Involves an obstruction that prevents sounds from getting through the outer or middle ear
• Sensorineural hearing loss: Involves how the inner ear or hearing nerve works
• Mixed hearing loss: Includes both a conductive and a sensorineural hearing loss
• Auditory neuropathy spectrum disorder: Involves a problem with how sound information is transmitted to the brain1

Each type of hearing loss has its own characteristics, causes, and treatment possibilities. Some types respond well to medical treatment or surgery, while others benefit most from hearing aids or other assistive devices.

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Conductive Hearing Loss

This type of hearing loss in the outer or middle ear where sound waves are not able to carry all the way through to the inner ear. Sound may be blocked by earwax or a foreign object located in the ear canal. Or the middle ear space might be impacted with fluid, infection, or a bone abnormality; another possible cause is an injury to the eardrum2.

In many cases, conductive hearing loss is treatable by medication or surgery, but it depends on the cause. If a medical condition causing conductive hearing loss isn’t treated, the hearing loss could become permanent.

Symptoms can vary depending on the precise cause of hearing loss, but some common signals include:

• You often think others are mumbling and ask them to repeat themselves.
• Sounds are muffled.
• You’re turning up the volume on the TV louder than usual.
• You might start speaking too softly or too loudly.
• You’re experiencing listening fatigue and might start avoiding social situations.
• A feeling of fullness or stuffiness in their ears
• Pain or tenderness in ears
• Dizziness
• Difficulty hearing soft sounds3

Want to learn more about the different types of hearing loss? Watch our video below with Audiologist Dr. Brad Ingrao.

Treatment for Conductive Hearing Loss

Your health care provider will likely do “active surveillance,” which essentially means keeping an eye on your hearing difficulty and monitor your hearing in subsequent appointments. If your hearing doesn’t improve or worsens, they will likely refer you to hearing health specialists such as an ear, nose, and throat doctor (ENT) and/or an audiologist who can test your hearing with more precision.

They might recommend a hearing aid or medical or surgical interventions for this type of hearing loss as well, including:

• Earwax removal
• Antibiotics for ear infections
• Surgery to repair eardrum perforations or damage to middle ear bones
• Bone-anchored hearing aids for chronic ear problems

Sensorineural Hearing Loss

Sensorineural hearing loss relates to problems with the inner ear, cochlea, and/or the auditory nerve4. This type of hearing loss can happen suddenly or over several days and commonly occurs when some of the hair cells in the cochlea get damaged5.

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The job of those hair cells is to convert sound waves into signals your brain can interpret as sounds. When hair cells are damaged, however, they don’t regenerate, which is why sensorineural hearing loss is typically permanent.

Common causes of sensorineural hearing loss include:

• Aging (the most common cause and typically irreversible)
• Prolonged exposure to loud noise such as industrial machinery or gunfire
• Certain medications (ototoxic drugs)
• Genetics
• Head trauma
• Viral infections like measles or mumps
• Autoimmune diseases such as lupus or rheumatoid arthritis6
• Meniere's disease7

If you’re experiencing sensorineural hearing loss, you might hear a ringing or buzzing in your ears, which might be tinnitus. Other signs of sensorineural hearing loss include:

• Difficulty following conversations when two or more people are talking
• Difficulty hearing in noisy areas.
• Higher-pitched voices, such as women's or children’s voices, are harder to hear than men’s voices
• It’s hard to distinguish high-pitched sounds such as “s” or “th”
• Other people's voices sound mumbled or slurred.
• You have problems hearing when there is background noise8.

Treatment for Sensorineural Hearing Loss

In addition to keeping an eye on hearing, which could involve hearing tests and follow-up tests, your doctors or specialists might recommend:

• Corticosteroids (anti-inflammatory medicine given orally or via injection through the eardrum) might be prescribed to reduce cochlear hair cell swelling and inflammation after exposure to loud noises.
• Surgery
• Hearing devices such as hearing aids or cochlear implants, depending on the cause and severity of your hearing loss

Mixed Hearing Loss

Mixed hearing loss is exactly what it sounds like: a combination of both conductive and sensorineural hearing loss. Someone might have age-related inner ear damage along with a middle ear infection, for example. This can make a specific diagnosis more challenging for health care providers.

Treatment for Mixed Hearing Loss

Treatment might require managing the conductive component first, such as a prescription medication to clear up an infection. Once that's addressed, hearing aids or other devices can help compensate for the sensorineural component of your hearing loss.

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Our tech experts and resident audiologist Dr. Ruth Reisman. has tested many hearing aids that may be suitable for mixed hearing loss, including ReSound and Oticon. Visit your hearing care professional to learn more about which brands may be right for you.

Auditory Neuropathy Spectrum Disorder

This type of hearing loss occurs when sound is able to enter the ear normally, but damage to the inner ear or the hearing nerve prevents sound from being processed in a way the brain can understand10.

Causes of auditory neuropathy spectrum disorder include:

• Damage to the inner hair cells, specialized sensory cells in the inner ear
• Damage to the auditory neurons that transmit sound information from the hair cells to the brain
• Genetic mutations
• Damage to the auditory system, which may result in faulty connections between the inner hair cells and the auditory nerve or damage to the auditory nerve itself11

Bottom Line

If you’re experiencing hearing loss, it can help to have a holistic approach beyond just medical treatment. Create a hearing-friendly environment at home by adding visual alerts for doorbells and smoke detectors, improving lighting for better lip-reading visibility, and reducing background noise where possible.

Understanding your type of hearing loss empowers you to make informed decisions about your hearing health. Whether you're dealing with conductive, sensorineural, or mixed hearing loss, there are treatment options that can help you maintain your hearing health and quality of life.

Expert Insights

From Dr. Ruth Reisman, Audiologist

When someone tells me they’ve been struggling to hear for years, I often wish they had come sooner. Addressing hearing concerns early doesn’t just protect your ears, it protects your connections with family, friends, and the world around you. If you’re feeling frustrated, isolated, or worn out from straining to listen, you’re not alone. Those are common experiences with hearing loss, and the good news is we have ways to help you reconnect and feel more confident again.