If your hearing report says conductive, sensorineural, or mixed, it’s describing where the difficulty occurs along the hearing pathway. The type can help guide the next step, such as an ear examination, specialist assessment, or a discussion about hearing aids.
Two people may both say that voices sound muffled and have different test findings. An audiologist uses your history, an ear examination, and hearing tests to work out what the pattern suggests. See what happens during a hearing test.
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What Are the Three Types of Hearing Loss?
| Type | Where the difficulty occurs | Example |
|---|---|---|
| Conductive | Sound has difficulty passing through the outer or middle ear. | Wax blocks the ear canal, or fluid affects sound transmission in the middle ear. |
| Sensorineural | The difficulty involves the inner ear or the nerve that carries hearing signals. | Inner-ear changes associated with ageing or loud noise exposure. |
| Mixed | The same ear has both a conductive and a sensorineural component. | Someone with existing inner-ear hearing loss also develops a middle-ear problem. |
Conductive hearing loss
Sound travels through the ear canal to the eardrum and then through the small bones of the middle ear. A problem along that route can make sounds harder to hear. The next step depends on what the clinician finds. For example, a wax blockage and a problem behind the eardrum call for different assessments. Read about muffled hearing.
Sensorineural hearing loss
This type involves the inner ear or hearing nerve. It can develop gradually, as with many age-related hearing changes, or occur suddenly. Some people first notice that voices are audible but hard to understand in a busy room. Read about age-related hearing loss or difficulty hearing in background noise.
Mixed hearing loss
Mixed hearing loss means both components are present in the same ear. If a clinician can address the conductive component, you may still need support for the sensorineural component. Ask which part of the test points to each and whether treating one component would change what support you need.
How Can a Hearing Test Tell the Types Apart?
An audiologist may compare two ways of delivering tones:
- Air conduction. You listen through headphones or ear inserts. The sound travels through the outer and middle ear before reaching the inner ear.
- Bone conduction. A small device against the skull sends vibrations to the inner ear, bypassing the outer and middle ear.
Here’s how the comparison can help. If you hear a tone at a softer level through bone conduction than through earphones, that difference can point to a conductive component. Audiologists call this an air–bone gap. If both sets of thresholds show hearing loss and there is also a significant gap, the pattern can suggest mixed hearing loss. The audiologist interprets the full set of results, including other tests where needed. See how to read an audiogram.
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What to Ask About Your Results
Ask the audiologist to point to the findings for each ear and explain what they suggest. If you received a printed audiogram, bring it to any follow-up visit.
- Which type of hearing loss do the results suggest in each ear?
- What findings led to that interpretation?
- Do I need a medical review or more testing?
- How do the results relate to the situations where I struggle to hear?
Mention ringing, pressure, or dizziness, especially if they started around the same time as the hearing change. If your hearing drops suddenly, seek medical care immediately, even if the ear feels plugged. Tell the medical team when you first noticed the change. Read about sudden hearing loss.
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