Types Of Hearing Loss: Recognize And Manage

by Dr. Beverly R. Johannsen

Knowing what type of hearing loss, you are having will be highly beneficial for you to improve the quality of life. The four main types of hearing loss are sensorineural hearing loss, conductive hearing loss, mixed hearing loss, and auditory neurothopy spectrum disorder. Let’s review the types of hearing loss here.

Sensorineural Hearing Loss

Sensorineural hearing loss occurs when there is a defect in the function of either your inner ear or the auditory nerve, which interferes in the transmission of sound or nerve signals to the brain.

Causes: Sensorineural hearing loss can begin both early and later in life. Sensorineural hearing loss which occurs at birth of a baby is called congenital sensorineural hearing loss. It is probably a result of an unknown cause, a genetic syndrome, or an infection passed from mother to fetus inside the womb.  The "infections" could be toxoplasmosis, rubella, herpes, or birth injury.

Aging, exposure to loud noises for a prolonged time, infections, or trauma are causes of Sensorineural hearing loss occurring later in life.

Symptoms: Both the loudness (intensity) and the clarity of sounds heard by you are affected by sensorineural hearing loss which leads to the following symptoms:

  • Noises may appear too loud or too quiet
  • Words of people can be heard but not understood (distorted perception)
  • Problem in understanding a conversation when two or more people are speaking simultaneously
  • A continuous ringing or buzzing in the ears (tinnitus)
  • Problems listening in noisy environments (train stations, construction sites, concerts, sports arenas)
  • Difficulty in hearing women's or children's voices
  • The sh or th sound are particular speech sounds that cannot be heard during conversations
  • Imbalance or dizziness 

Conductive Hearing Loss

Conductive hearing loss occurs when there is a defect in the function of your outer or middle ear due to damage or obstruction, which inhibits the conduction of sound to the inner ear.

Causes: The conductive hearing loss can affect either your outer or middle ear:

The impaction of wax can block the outer ear, narrowing of the ear canal (stenosis), foreign bodies and inflammation (Otitis externa, also called swimmer's ear).

Perforation or thickening of the eardrum, infection of the middle ear (Otitis Media), or accumulation of fluid in the middle ear can cause damage. The adherence of the middle ear bones (Otosclerosis) can also cause damage to the ear. Finally, damage can occur from a break or disruption in the ossicular bones due to injury and obstruction in the Eustachian tube, which connects the middle ear to the back of the nose and throat.

Symptoms: The symptoms of conductive hearing loss depend upon whether the damage is in your outer or middle ear. The loudness of sound is diminished, so it is perceived as soft if the outer ear has damage or obstruction. Both frequency and loudness of sounds heard by you are decreased if the middle ear is affected. The high and low tones may be either softer or louder. The symptoms of conductive hearing loss include:                                                                                                                                          

  • Switching up the volume of the radio or television to a high volume
  • Problem with hearing people on the phone
  • Being able to hear better from one of the ears
  • Symptoms indicating infection such as pain, sensation of pressure in one or both ears, foul odor from the ear canal

Mixed Hearing Loss

Mixed hearing loss combines both the sensorineural and conductive hearing loss.

Causes: The most common cause of mixed hearing loss is trauma to the ear. It is also caused when one hearing loss is added on to the existing hearing loss with gradual progression of symptoms. For example, age-related hearing loss may occur as you get older along with a long-standing conductive hearing loss. On the other hand, a temporary mixed hearing loss may be caused by the impaction of wax if you already have age-related hearing loss.

Symptoms: The indicators of mixed hearing loss will include blended symptoms of both the sensorineural loss and conductive hearing loss

Auditory Neuropathy Spectrum Disorder

Auditory Neuropathy Spectrum Disorder occurs when the inner ear can detect the sound, but has difficulty with transmitting sound from the ear to the brain. People of all ages, from infancy to adulthood, can be affected.                                                                                                                                            

Causes: Auditory Neuropathy Spectrum Disorder can occur due to abnormalities at birth, such as low birth weight, prematurity, decreased oxygen to a baby's brain (hypoxia at birth), congenital malformations. During childhood and adulthood, you can get Auditory Neuropathy Spectrum Disorder as a complication of viral diseases, seizures, and high fever.                                                                                                                                                             

Symptoms: In Auditory Neuropathy Spectrum Disorder, there is a decrease in speech-perception abilities. It implies that you have trouble understanding speech clearly. The sounds can be heard with some degree of hearing loss which can be fluctuating.

Management Of Types Of Hearing Loss

The management choices for the hearing loss will vary as per the type of hearing loss.

  • For conductive hearing loss, the management will depend on the underlying cause. Both medical treatment and surgical procedures are used in managing the hearing concerns.
  • For sensorineural hearing loss, hearing aids or implantable devices may be the best choice.
  • The management of mixed hearing loss will vary according to the predominance of the hearing loss, whether sensorineural or conductive hearing loss.
  • The management of Auditory Neuropathy Spectrum Disorder includes the use of assistive therapy to promote understanding of sounds and development of speech such as audio-verbal therapy and the use of hearing aids or cochlear implants.

Identifying the type of hearing loss facilitates the management of your hearing loss. You have several options to choose from our selection of hearing aids. We are at your disposal to assist you in the selection process.


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