Types of hearing loss
Types of hearing loss
Named by where they happen, not how bad they are
The three names you will hear most often — conductive, sensorineural and mixed — describe where in the ear the problem sits. They say nothing about severity. A conductive loss can be significant and a sensorineural loss can be slight.
Conductive loss sits where sound is carried. Sensorineural loss sits where sound is converted into nerve signals. Mixed loss involves both.
Conductive hearing loss
Something in the outer or middle ear is getting in the way of sound reaching the inner ear. The inner ear itself may be working perfectly well.
Common reasons:
- Wax blocking the ear canal
- Fluid behind the eardrum
- A perforated eardrum
- Problems affecting the three small middle-ear bones
Sound tends to seem muffled or quiet rather than distorted, because the inner ear is still processing normally — there is simply less getting to it.
Sensorineural hearing loss
The inner ear or the hearing nerve is not converting or carrying sound as it should. This is the most common type of permanent hearing loss in adults.
Common reasons:
- Age-related change in the inner ear
- Long-term exposure to loud sound
- Some illnesses and some medicines
- Changes present from birth, or inherited
Volume is only part of the picture. Clarity is often affected too, which is why turning things up does not always help as much as people expect.
Mixed hearing loss
Mixed hearing loss means both are present at once — a conductive component sitting on top of a sensorineural one. A common example is someone with long-standing age-related change who also has a build-up of wax.
It matters because the two parts may be addressed differently. Clearing a conductive component can change what someone hears without changing the sensorineural part at all.
Some authorities list a fourth type
You will see this described as three types on most websites, and as four on others. The US Centers for Disease Control and Prevention separates out auditory neuropathy spectrum disorder, where sound reaches the inner ear normally but is not passed along to the brain in an organised way.
We mention it because you may encounter both framings and wonder which is right. Neither is wrong — they are different levels of detail, and the three-type grouping remains the most widely used in general explanation.
How they are told apart
How the type is identified
A hearing test does not just measure how much you hear — it is set up to show where the difficulty sits.
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Looking in the ear
An otoscope shows whether anything obvious is blocking the canal or sitting behind the eardrum. Some conductive causes are visible in seconds.
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Testing through the ear canal
Sounds are played through headphones, travelling the normal route through the outer and middle ear to the inner ear.
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Testing past the middle ear
Sound is also delivered in a way that reaches the inner ear more directly. If hearing is better by that route than through the canal, that points to a conductive component.
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Comparing the two
The gap between those two sets of results is what separates conductive from sensorineural — and shows when both are present.
Common questions
Which type of hearing loss is most common?
In adults, sensorineural hearing loss is the most common permanent type, largely because age-related change falls into that category. Conductive causes such as wax are also extremely common, but are often temporary.
Can you have a different type in each ear?
Yes. Each ear is tested separately for exactly this reason. It is entirely possible to have a conductive problem in one ear and normal hearing, or a different type of loss, in the other.
Does the type change what can be done about it?
It is one of the main things that changes it. A conductive component caused by wax or fluid is approached quite differently from permanent inner-ear change, which is why identifying the type comes before any discussion of options.
Is conductive hearing loss always temporary?
No. Some conductive causes resolve or can be treated, and others are long-standing — for example changes affecting the middle-ear bones. Temporary and conductive are not the same word.
What does "sensorineural" actually mean?
It is two words joined: sensory, meaning the inner ear, and neural, meaning the hearing nerve. The term covers both because a standard hearing test cannot always separate them.
If you want your own hearing checked
Book a hearing appointment
This page is general information. A hearing test measures your own hearing and is the only way to know where yours sits.
Sources
- New Zealand Audiological Society — About hearing loss
- NZAS — What causes hearing loss?
- US Centers for Disease Control and Prevention — Types of hearing loss
- Health New Zealand — Hearing loss in adults
- World Health Organization — Deafness and hearing loss — fact sheet
This page is general information, not a diagnosis or individual advice.
Hearing with Heart
Audiology & Ear Hygiene
Unit 34, The Acres,
Halswell, Christchurch 8025,
New Zealand