There are three types of hearing loss: sensorineural, conductive and mixed (sensorineural and conductive). These can be congenital or acquired.
Noise exposure is the most common cause of hearing loss. A short blast of loud noise, such as a gunshot, can damage the cells in your inner ear.
Conductive
Conductive hearing loss occurs when sound cannot pass through the outer ear or middle ear to reach the inner ear. A conductive hearing loss can happen in one or both ears, and it usually affects children and adults.
There are several types of conductive hearing loss, depending on the cause. Treatment may involve medications or surgery. It is important to treat any hearing loss as soon as possible.
A person with a conductive hearing loss often has problems understanding speech or hearing the TV or radio. They might also have trouble turning up the volume on their devices.
The most common conductive hearing loss is caused by the accumulation of wax in the external ear canal, commonly known as cerumen (earwax). Doctors may be able to remove this buildup by using an ear canal cleaner.
Another common conductive hearing loss is caused by fluid behind the eardrum. This happens when the eustachian tube, which connects the ear to the back of the throat, is blocked or doesn’t open and drain properly.
This can cause a lot of pressure to be placed on the eardrum, which can lead to an infection. It can also block the flow of air to the inner ear and prevent it from functioning normally.
An ENT doctor can determine if you have a conductive hearing loss by asking questions and performing tests. These include an audiogram and a tympanometry test. They can also check if there is any fluid behind the eardrum, which may indicate that your eardrum has become damaged or has holes in it.
If you have a conductive hearing loss, your ENT will want to find the source of the problem. This may be as simple as cleaning out the ear canal with a special tool. Other times, a foreign body can be removed with microsuction.
The ENT can also conduct a test called the Rinne test. In this test, a vibrating 512-Hz tuning fork is held against the mastoid process, until the patient can no longer hear it. The still-vibrating tines are then positioned 1cm away from the external acoustic meatus. If bone conduction is heard better than air conduction, it indicates that a conductive hearing loss is present.
These tests can be used to help diagnose conductive hearing loss, as well as other hearing disorders. A tympanometry test can also be performed to measure the pressure in your ear and detect any abnormal movement of your eardrum.
This type of hearing loss can be treated with certain medications and surgical treatments, such as tympanostomy tubes or middle-ear implants. Your ENT can recommend the best treatment for you.
Conductive hearing loss can also be treated with hearing aids, which are devices that allow sounds to reach the inner ear. These devices are available in a variety of styles and are very comfortable to wear. You can try them for free to see if they’re right for you.
Sensorineural
In this type of hearing loss, there is damage to the inner ear and or problems with the nerve pathways between the ear and the brain. This type of hearing loss is usually permanent, although some cases can be repaired with medicine or surgery.
A spiraling organ in the inner ear called the cochlea contains tiny hairs that convert vibrations of sound waves into neural signals that are sent to your auditory nerve. This nerve then sends the neural signals to your brain. When these hairs are damaged, the sounds you hear become unclear or muffled.
Sensorineural hearing loss can be genetic or acquired. It can be present at birth (congenital), or it may begin later in life as a result of exposure to noise, illness, trauma or natural aging processes.
SNHL is often associated with other symptoms, such as tinnitus and balance problems (vertigo). The patient may also experience a gradual decline in hearing thresholds that takes years or decades to develop.
The diagnosis of SNHL is based on the history and physical examination. Patients should have a thorough audiogram performed that chart the thresholds of hearing at various frequencies. The most common audiogram is pure tone audiometry, which charts the sensitivity at a range of standard frequencies between 250 and 8000 Hz.
It is important to remember that many people with SNHL have mixed hearing loss which is an inherited or acquired problem with both the outer and middle ear. This can be a challenge to diagnose and treat because of the presence of conductive losses, which are not typically accompanied by hearing loss in the other ear.
However, the majority of mixed hearing loss will have sensorineural hearing loss. Surgical treatment can sometimes be recommended, but in the vast majority of patients with this combination of hearing loss, conservative measures and hearing aids will allow a good quality of life.
If the SNHL is severe, patients are likely to require surgical intervention with a cochlear implant. This implant is designed to help re-establish communication by making sounds louder.
When a patient is diagnosed with SNHL, the physician needs to work with an interprofessional team including otolaryngologists, neuroradiologists and audiologists. The physicians should educate the patient and family about the hearing loss, possible causes of the hearing loss, and the different options for treating it.
In some cases, a patient’s SNHL is caused by an acoustic neuroma, which is a tumor that forms in the auditory nerve. Magnetic resonance imaging of the brain with gadolinium is the gold standard for diagnosing these tumors.
SNHL is the most common type of hearing loss in adults and affects a large portion of the population at some point in their lives. It is a chronic condition that can cause significant psychosocial problems and requires ongoing support from the physician, the patient and their family.
Mixed
Mixed hearing loss is a type of hearing loss that has elements of both conductive and sensorineural hearing loss. It is a very common condition and can be caused by a variety of factors, including certain drugs or medications that are ototoxic.
Conductive hearing loss occurs when sound waves cannot reach the inner ear, or cochlea. This can happen because of earwax buildup, otosclerosis or other conditions in the outer or middle ear. This type of hearing loss can be permanent or temporary and can be treated with a variety of medical procedures and devices, such as hearing aids.
Sensorineural hearing loss is also a common form of hearing loss and occurs when the sound signals don’t travel through the auditory nerve to the brain. This type of hearing loss can be genetic or acquired and can occur in both children and adults.
Some hearing issues are hereditary, while others develop after a trauma or infection. Generally, these types of hearing issues are more common in infants and children and often appear at the same time or right after birth.
Fortunately, many of the causes of this type of hearing loss can be prevented. If you suspect a hearing problem, it is always best to get tested sooner rather than later.
It is also a good idea to ask about your family’s history of hearing problems. This can help your doctor diagnose your condition and recommend the most appropriate treatment.
If you have mixed hearing loss, it is important to treat the component of your loss that is conductive first, as this may help reduce the severity of your symptoms. You can then address the sensorineural portion with a combination of surgical procedures and other medical treatments.
A hearing specialist will be able to determine the root cause of your symptoms and determine which of the two types of hearing loss you are experiencing. They will then provide personalized professional guidance and an action plan that addresses your specific needs and goals.
You will be referred to an experienced audiology provider near you for a comprehensive evaluation. During this visit, your provider will take a detailed history and perform a range of tests to determine which type of hearing loss you have.
They will then assess the condition of your eardrum, middle ear, and cochlea (hearing organ) to pinpoint the source of the problem. This can include a CT scan of the ears.
Once your hearing specialist determines the underlying cause of your hearing loss, they will prescribe an action plan to correct it. This can include surgery to remove a blockage in the ear canal or a bone-anchored hearing device that can be placed behind your ear.
Some causes of this type of hearing loss are genetic and some are due to ototoxic medications or diseases, such as ear infections or cancer. Other causes include otosclerosis and some traumatic injuries to the ear or brain.
