Hearing loss is common, especially as we age. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), about 1 in 3 adults ages 65 to 74 has hearing loss. For adults age 75 and older, that number increases to nearly half.
Hearing loss can have many causes, from earwax buildup and ear infections to aging, loud noise exposure and certain medical conditions. Understanding what type of hearing loss you have is an important first step toward finding the right treatment.
What Are the 3 Types of Hearing Loss?
There are three main types of hearing loss: conductive, sensorineural, and mixed hearing loss. Each affects the ear differently and may require different treatment.
- Conductive hearing loss: Occurs when a problem in the outer or middle ear prevents sound from reaching the inner ear.
- Sensorineural hearing loss: Occurs when there is damage to the inner ear or the auditory nerve that carries sound signals to the brain.
- Mixed hearing loss: A combination of conductive and sensorineural hearing loss.
Let's take a closer look at each type.
1. Conductive Hearing Loss
Conductive hearing loss occurs when a problem in the outer or middle ear prevents sound from traveling properly to the inner ear. This type of hearing loss may be temporary or treatable, depending on its cause.
Symptoms of Conductive Hearing Loss
Common symptoms may include:
- Muffled or reduced hearing
- A feeling of fullness or pressure in the ear
- Difficulty hearing softer sounds
- Hearing loss in one or both ears
- Difficulty hearing certain pitches
- Sounds seeming quieter than usual
Causes of Conductive Hearing Loss
Conductive hearing loss can have many causes, including:
- Earwax buildup
- Fluid in the middle ear
- Ear infections
- Allergies
- A perforated or damaged eardrum
- Problems with the Eustachian tube
- A foreign object in the ear
- Abnormalities of the ear canal or middle-ear bones
- Growths or tumors
In some cases, conductive hearing loss can be improved or reversed by treating the underlying cause. For example, medication may be used to treat an ear infection, while a healthcare professional can safely remove impacted earwax. Some structural problems may require a surgical procedure.
If you experience sudden hearing loss, particularly in one ear, seek medical attention promptly.
2. Sensorineural Hearing Loss
Sensorineural hearing loss is the most common type of permanent hearing loss. It occurs when there is damage to the inner ear, particularly the sensory cells in the cochlea, or to the auditory nerve pathways that carry sound information to the brain.
Age-related hearing loss, also called presbycusis, is one of the most common causes of sensorineural hearing loss.
Symptoms of Sensorineural Hearing Loss
Symptoms may include:
- Muffled speech or sounds
- Difficulty understanding conversations
- Trouble hearing when there is background noise
- Difficulty hearing high-pitched sounds
- Ringing or buzzing in the ears
- Needing to turn up the television or radio
- Frequently asking others to repeat themselves
- Difficulty hearing on the telephone
- Dizziness or balance problems in some cases
Causes of Sensorineural Hearing Loss
Sensorineural hearing loss may be caused by:
- Aging
- Long-term exposure to loud noise
- Certain medications
- Head or ear injuries
- Viral or bacterial infections
- Certain autoimmune conditions
- Ménière's disease
- Hereditary or genetic factors
- Certain tumors or disorders affecting the auditory nerve
- Other conditions affecting the inner ear
Damage to the sensory cells of the inner ear generally cannot be reversed. However, treatment can help people hear and communicate more effectively.
Hearing aids may amplify sounds to make them easier to hear. For people with severe or profound hearing loss who do not benefit enough from hearing aids, a cochlear implant may be an option. An audiologist or other hearing specialist can help determine which treatment is appropriate.
3. Mixed Hearing Loss
Mixed hearing loss is a combination of conductive and sensorineural hearing loss. This means a person has both a problem affecting the outer or middle ear and damage involving the inner ear or auditory nerve. For example, someone may have age-related sensorineural hearing loss along with a buildup of earwax or another condition affecting the middle ear.
Symptoms of Mixed Hearing Loss
Because mixed hearing loss combines two types of hearing loss, symptoms may include those associated with both conductive and sensorineural hearing loss, such as:
- Muffled sounds
- Difficulty understanding speech
- Trouble hearing in noisy environments
- A feeling of fullness in the ear
- Ringing in the ears
- Difficulty hearing soft or high-pitched sounds
Treatment depends on the underlying causes. A healthcare professional may first address the conductive component while also recommending treatment for the sensorineural component, such as hearing aids.
How Is Hearing Loss Diagnosed?
If you notice changes in your hearing, talk with your primary care provider. Depending on your symptoms, your provider may recommend a hearing test or refer you to an audiologist or an ear, nose, and throat specialist (ENT).
Hearing tests can help determine:
- Whether hearing loss is present
- Which ear is affected
- The type of hearing loss
- The severity of the hearing loss
- How well you understand speech
Common Types of Hearing Tests
Several tests may be used to evaluate hearing.
Pure-tone audiometry: This test determines the softest sounds you can hear at different pitches and frequencies.
Speech testing: Speech and word recognition tests evaluate how well you can hear and understand spoken words at different volumes and, in some cases, in background noise.
Tympanometry: This test evaluates how well the eardrum and middle ear are functioning and can help identify problems such as fluid behind the eardrum.
Acoustic reflex testing: Also called middle ear muscle reflex testing, this evaluates how the muscles in the middle ear respond to loud sounds.
Tuning fork tests: These simple tests can help healthcare professionals identify the type and location of hearing loss.
The results of your hearing evaluation can help your healthcare team determine the best approach for treatment and hearing management.
When Should You See a Doctor About Hearing Loss?
Don't ignore changes in your hearing. Even gradual hearing loss can make it harder to communicate with family and friends, participate in social activities, and stay connected to the people around you.
Talk with your healthcare provider if you:
- Frequently ask people to repeat themselves
- Have trouble following conversations
- Struggle to hear when there is background noise
- Turn the television volume up higher than others prefer
- Notice ringing or buzzing in your ears
- Feel that one or both ears are plugged
- Notice a gradual decline in your hearing
Sudden hearing loss requires prompt medical evaluation. If you experience sudden hearing loss in one or both ears, contact a healthcare professional right away.
Take the First Step Toward Better Hearing
Hearing loss is common, but it doesn't have to keep you from enjoying conversations, staying socially connected, or participating in the activities you love.
The first step is understanding what is causing your hearing loss and what type you have. Your healthcare provider can help evaluate your symptoms and determine whether additional testing or treatment is needed.
If you're experiencing changes in your hearing, talk with your primary care provider about your concerns. The right evaluation and treatment can help you stay connected and maintain your quality of life.
Frequently Asked Questions About Hearing Loss
What are the 3 main types of hearing loss?
The three main types of hearing loss are conductive, sensorineural, and mixed hearing loss. Conductive hearing loss involves the outer or middle ear, sensorineural hearing loss involves the inner ear or auditory nerve, and mixed hearing loss combines both types.
What is the most common type of permanent hearing loss?
Sensorineural hearing loss is the most common type of permanent hearing loss. Aging and long-term exposure to loud noise are common causes.
Can conductive hearing loss be reversed?
In some cases, yes. Conductive hearing loss may improve when its underlying cause is treated. Depending on the cause, treatment may include removing earwax, treating an infection, or addressing a structural problem.
Can sensorineural hearing loss be cured?
Damage to the sensory cells of the inner ear generally cannot be reversed. However, treatments such as hearing aids and, for some people, cochlear implants can improve hearing and communication.
How do doctors determine what type of hearing loss I have?
A healthcare professional may use a combination of hearing tests, including pure-tone audiometry, speech testing, tympanometry, and other evaluations. The results help determine the type and severity of hearing loss.
