Types of Hearing Loss: Sensorineural, Conductive & Mixed
Key takeaways
- The three main types of hearing loss are sensorineural, conductive, and mixed.
- Sensorineural hearing loss — the most common type in adults — results from damage to the inner ear or auditory nerve and is usually permanent.
- Conductive hearing loss involves a problem in the outer or middle ear that blocks sound from reaching the inner ear; it is often treatable.
- Mixed hearing loss combines elements of both sensorineural and conductive loss.
- An audiologist can determine the type and degree of hearing loss through a comprehensive hearing evaluation.
Not all hearing loss is the same. The type of hearing loss you have — where in the auditory system the problem originates — determines what caused it, how it affects your hearing, and what treatment options are available. There are three main types: sensorineural, conductive, and mixed.
Sensorineural hearing loss
Sensorineural hearing loss (SNHL) is the most common type of hearing loss in adults. It results from damage to the hair cells in the cochlea (the inner ear) or to the auditory nerve that carries sound signals to the brain. Once these hair cells are damaged, they do not regenerate.
Common causes
- •Aging (presbycusis) — the most common cause in adults over 60
- •Noise exposure — prolonged or sudden loud sound
- •Certain medications (ototoxic drugs)
- •Viral infections such as mumps, measles, or meningitis
- •Genetic factors
- •Head trauma
- •Meniere's disease
Characteristics
SNHL typically affects high-frequency sounds first, making consonants harder to distinguish. Speech may sound muffled or unclear even when it is loud enough. It is usually permanent, but hearing aids are often highly effective at improving communication.
Conductive hearing loss
Conductive hearing loss occurs when sound cannot travel efficiently through the outer or middle ear to reach the inner ear. Unlike sensorineural loss, conductive hearing loss is often temporary and treatable.
Common causes
- •Earwax (cerumen) blockage
- •Fluid in the middle ear (otitis media with effusion)
- •Ear infections
- •Perforated eardrum
- •Otosclerosis (abnormal bone growth in the middle ear)
- •Malformation of the outer or middle ear
- •Foreign object in the ear canal
Characteristics
Conductive hearing loss often makes sounds seem quieter or muffled. Because the inner ear is intact, speech understanding is usually preserved once sounds are loud enough. Treatment may include earwax removal, medication, surgery, or hearing aids depending on the cause.
Mixed hearing loss
Mixed hearing loss involves both a sensorineural component and a conductive component occurring at the same time. For example, a person might have age-related inner ear damage (sensorineural) combined with a middle ear infection (conductive). Treatment typically addresses the conductive component first, then evaluates the remaining sensorineural loss.
A note on auditory processing disorder
Auditory processing disorder (APD) is sometimes confused with hearing loss. In APD, the ears function normally but the brain has difficulty processing auditory information. APD is diagnosed differently from peripheral hearing loss and requires evaluation by an audiologist with specialized training.
How is the type of hearing loss determined?
An audiologist determines the type of hearing loss through a comprehensive hearing evaluation that includes pure-tone audiometry with both air conduction (through headphones) and bone conduction (through a vibrating device placed behind the ear). Comparing the two sets of results reveals whether the loss is sensorineural, conductive, or mixed.
Learn how to read an audiogram →
Frequently asked questions
Can sensorineural hearing loss be cured?
In most cases, sensorineural hearing loss is permanent. However, it can often be effectively managed with hearing aids or, in cases of severe to profound loss, cochlear implants. Research into hair cell regeneration is ongoing but has not yet produced clinically available treatments.
Is conductive hearing loss always temporary?
Not always, but many causes of conductive hearing loss — such as earwax blockage, ear infections, or fluid in the middle ear — are treatable. Some structural causes, such as otosclerosis, may require surgery.
Can I have both types at the same time?
Yes. Mixed hearing loss involves both sensorineural and conductive components. It is not uncommon, particularly in older adults who may have age-related inner ear changes alongside a middle ear problem.
Sources
- 1. National Institute on Deafness and Other Communication Disorders (NIDCD). Hearing Loss. nidcd.nih.gov. Accessed September 2026.
- 2. American Speech-Language-Hearing Association (ASHA). Types of Hearing Loss. asha.org. Accessed September 2026.
- 3. Cunningham LL, Tucci DL. Hearing Loss in Adults. New England Journal of Medicine. 2017;377(25):2465–2473.