The ear is made up of three spaces: The outer ear, the middle ear, and the inner ear. There are also three types of hearing loss. The part of the ear affected determines which type of hearing loss the patient may present with. The type of hearing loss also determines whether hearing aids or medical intervention is required.

Conductive Hearing Loss

Conductive hearing losses occur when sound cannot transmit through the outer and middle ear. Patients may find that soft sounds are hard to hear, and loud sounds can seem muffled. Usually, a significant increase in volume is required for the patient to hear when experiencing a conductive hearing loss.


  • Fluid build up in the middle ear
  • Ear infections in outer (otitis externa) or middle (otitis media) ear
  • Hole in the ear drum
  • Ear wax build up
  • Problems with how outer or middle ear is formed (e.g., problem with function of three middle ear bones)

With conductive hearing losses, they can be temporary in nature or permanent in nature. Temporary causes, such as ear wax build up or an infection, requires medical intervention to treat the hearing loss. Conductive losses may require hearing aids if it is permanent in nature. For example, a longstanding hole in the ear drum that cannot be solved with surgery or medical intervention.

Sensorineural hearing loss

Sensorineural hearing loss occurs after damage has occured to the inner ear. Difficulty hearing in background noise can be the first sign of difficulty for those with sensorineural hearing loss. Overall difficulty hearing the television, feeling like people are mumbling, or difficulties hearing softer sounds are all indicators of a sensorineural hearing loss. More often than not, the speaker is not mumbling, and the hearing loss is the cause of the difficulties.


  • Age-related hearing loss (presbycusis)
  • Medications toxic to the inner ear
  • Family history of hearing loss
  • Excessive noise exposure over time
  • Concussions


Sensorineural hearing loss is permanent and irreversible in nature. Once there is damage to the inner ear, hearing aids are required and are the only form of treatment to improve hearing abilities.

Mixed Hearing Loss

Mixed hearing losses occur when the patient has damage to both the outer or middle ear, and inner ear. For example, if a patient with sensorineural hearing loss experiences an ear infection, they now present with a mixed hearing loss. A combination of hearing aids (to accommodate the sensorineural portion), and medical intervention (for the conductive portion) is usually the course of action for patients with mixed hearing loss.

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