Mixed hearing loss is when a person has conductive hearing loss at the same time as sensorineural hearing loss.

On this page, you can find out all about these types of hearing loss and what they mean.

What is mixed hearing loss?

The definition of mixed hearing loss is that there are elements of both conductive and sensorineural hearing loss.

An example of mixed hearing loss is a person with a growth in the ear canal (causing a conductive hearing loss) and damage to the inner ear (causing a sensorineural hearing loss) caused by acoustic trauma.

What does sensorineural hearing loss mean?

In the inner ear, the cochlea is shaped like a snail shell and converts sound vibrations into electrical impulses.

Sensorineural hearing loss means the inner ear or hearing nerve is damaged or unable to process sound as intended. This type of hearing loss can be genetic or acquired during a person’s life. It can affect people of all ages.

The inner ear and hearing nerve deliver a high-resolution signal to the brain for processing. When the inner ear is damaged, the sound's resolution reduces, making the sound not only quieter but less precise. It can also result in a decreased tolerance for louder sounds, making them uncomfortable.

Learn more about sensorineural hearing loss

What does conductive hearing loss mean?

Conductive hearing loss is when there is damage or an obstruction in the outer or middle ear. This prevents the sound waves from being effectively conducted from the outside world and into the inner ear.

There are different causes of conductive loss. These include a deformity in the ear’s anatomy, infection or disease, or damage to the outer ear or the bones (ossicles) in the middle ear, which prevent sound from being transmitted to the inner ear.

Learn more about conductive hearing loss here

What’s it like to have mixed hearing loss?

How much people with mixed hearing loss can hear depends on their level of hearing loss. Their hearing also depends on how much of the overall hearing loss is due to sensorineural hearing loss, and how much is due to conductive hearing loss in the outer or middle ear.

Learn more about hearing loss and its causes

The symptoms of mixed hearing loss

Since mixed hearing loss is a combination of sensorineural hearing loss and conductive hearing loss, the symptoms of mixed hearing loss are usually a mixture of the symptoms of each type of hearing loss.

See the symptoms of hearing loss here

Mixed hearing loss treatment

Mixed hearing loss is usually treated with hearing aids. Because there is mixed conductive and sensorineural hearing loss, the treatment needs to consider both of these elements. Treating mixed hearing loss can therefore require a combination of different approaches.

The conductive hearing loss element can often be treated through medical means, including physically removing problems such as impacted ear wax or objects in the ear canal, which block sound waves. If the conductive hearing loss is caused by infection, medicines such as antibiotics can be used to treat it.

In the case of physical abnormalities, tumors, or certain diseases, surgical procedures can repair the damage, such as patching holes in the eardrum or removing tumors or diseases such as cholesteatoma.

Implantable devices can also help with some types of conductive hearing loss resulting from middle ear damage. For disarticulated middle ear bones, there is a prosthesis called Total Ossicular Replacement Prosthesis (TORP). There are also bone-anchored hearing aids, which are implantable devices that can improve transmission loss.

The sensorineural portion of mixed hearing loss is treated with hearing aids. To learn more about the different hearing aids and options, see this article on hearing aids. Your hearing care specialist can help you select the best hearing aid treatment for you.

Implantable devices called cochlear implants can also be used to treat sensorineural hearing loss via a surgical intervention. Cochlear implants deliver sound to the ear by electrically stimulating the hearing nerve with tiny electrical impulses. This uses a small array implanted in the cochlea (inner ear organ) and a magnet surgically embedded in the skull behind the ear. There is also an external receiver and hearing device. This is an option for people with more significant hearing loss who receive little or no benefit from conventional hearing aids.

Causes of mixed hearing loss

Because mixed hearing loss is a combination of conductive and sensorineural hearing loss, there is always more than one individual cause of mixed hearing loss.

Learn more about hearing loss and its causes