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Hearing loss affects millions of people around the world, and in Singapore, it’s more common than you might think. Whether due to age, noise exposure, illness, or genetics, hearing loss can significantly impact daily life. But did you know that not all hearing loss is the same?
Understanding the different hearing loss categories can help you recognise the symptoms, seek the right treatment, and better manage your hearing health. In this article, we’ll explore the types of hearing loss, the differences between conductive vs sensorineural, and what happens when both types combine into mixed hearing loss.
We’ll also explain how hearing tests work and where to get help if you think you’re experiencing hearing problems.
What Are the Main Hearing Loss Categories?
There are three main types of hearing loss:
- Conductive Hearing Loss
- Sensorineural Hearing Loss
- Mixed Hearing Loss
Each category affects a different part of the ear and has its own set of causes and treatments. Let’s take a closer look.
Conductive Hearing Loss
What Is Conductive Hearing Loss?
Conductive hearing loss happens when sound cannot pass through the outer or middle ear. This makes soft sounds harder to hear, and loud sounds seem muffled. The inner ear and the hearing nerve usually work fine
Causes of Conductive Hearing Loss
Conductive hearing loss can be caused by several factors, including:
- Ear infections
- Earwax buildup
- Fluid in the middle ear
- Perforated eardrum
- Foreign objects in the ear canal
- Abnormal bone growth (otosclerosis)
Also, read about ear infection symptoms and middle ear infections for early detection and treatment tips.
Symptoms
- Muffled hearing
- Feeling of fullness or blockage in the ear
- Sudden or gradual hearing loss
- Ear pain or discomfort
- Trouble hearing on one side
Diagnosis and Treatment
A hearing test is the first step to diagnosis. Common testing methods include:
Treatment for conductive hearing loss depends on the cause:
- Earwax removal
- Antibiotics or antifungals for infection
- Surgical treatment in cases like otosclerosis
- Hearing aids amplify sound
Sensorineural Hearing Loss
What Is Sensorineural Hearing Loss?
Sensorineural hearing loss is the most common type and occurs when there is damage to the inner ear (cochlea) or the auditory nerve. This damage prevents sound signals from reaching the brain properly.
This type of hearing loss is usually permanent and cannot be cured, but it can be managed effectively with hearing devices or implants.
Causes of Sensorineural Hearing Loss
- Aging (presbycusis)
- Noise exposure (e.g., loud music, machinery)
- Head trauma
- Certain medications (ototoxic drugs)
- Viral infections
- Genetics
- Sudden sensorineural hearing loss (SSNHL)
Sudden hearing loss is a medical emergency. Read more about SSNHL and its causes here.
Symptoms
- Difficulty hearing high-pitched sounds
- Trouble understanding speech, especially in noise
- Tinnitus (ringing in the ears)
- No sensation of blockage, but hearing is still poor
Conductive vs Sensorineural: Key Differences
Feature | Conductive Hearing Loss | Sensorineural Hearing Loss |
Affected Area | Outer or middle ear | Inner ear or auditory nerve |
Sound Perception | Muffled or blocked | Distorted or unclear |
Common Cause | Infection, wax, fluid | Nerve damage, age, noise |
Reversibility | Often reversible | Usually permanent |
Treatment | Medical/surgical, hearing aids | Hearing aids, cochlear implants |
Mixed Hearing Loss
What Is Mixed Hearing Loss?
Mixed hearing loss is when a person has both conductive and sensorineural components. This means there is a problem in both the middle ear (e.g., fluid or blockage) and the inner ear or nerve.
It can happen when someone with long-standing sensorineural hearing loss develops an ear infection or vice versa.
Causes
- Chronic ear infections plus age-related hearing loss
- Head injury affecting multiple parts of the ear
- Conditions like otosclerosis that worsen over time
- Long-term noise exposure with middle ear issues
Symptoms
- Combination of muffled and distorted hearing
- Fluctuating hearing levels
- Greater difficulty in understanding speech
- Tinnitus may also be present
Treatment Options
Treatment for mixed hearing loss involves addressing both parts of the problem:
- Medical treatment for the conductive part
- Hearing aids for the sensorineural part
- Surgical options like cochlear implants in some severe cases
Diagnosing the Type of Hearing Loss
To identify which type of hearing loss you have, you need a full evaluation by a hearing professional. This includes:
- Medical History
- Otoscopy (ear inspection)
- Audiometry tests
- Tympanometry and acoustic reflex testing
- ABR and ASSR tests for deeper evaluation
Preventing Hearing Loss
While not all hearing loss is preventable, there are steps you can take to reduce your risk:
- Use ear protection in noisy places
- Turn down the volume on headphones
- Avoid inserting objects in your ears
- Treat ear infections quickly
- Get regular ear measurements
- Schedule annual hearing tests
Conclusion
Understanding the different hearing loss categories, conductive, sensorineural, and mixed hearing loss, is the first step to protecting and managing your hearing health. Each type has different causes, symptoms, and treatment options.
If you’re unsure about your hearing, visit The Hearing Centre Singapore for a full assessment and expert care. Early intervention can help you stay connected, confident, and in control of your hearing health.
Frequently Asked Questions
Sensorineural hearing loss is the most common type. It usually happens due to aging, long-term exposure to loud noise, or damage to the inner ear. This type of hearing loss tends to develop gradually and is often permanent.
Conductive hearing loss happens when sound can’t pass through the outer or middle ear, often due to blockages, infections, or fluid. It’s usually treatable. Sensorineural hearing loss affects the inner ear or auditory nerve and is typically permanent, requiring hearing aids or implants for management.
Mixed hearing loss is when someone has both conductive and sensorineural hearing issues. For example, someone might have inner ear nerve damage along with a perforated eardrum or fluid in the middle ear, making hearing more complex to treat.
Yes, hearing aids can help with most types of hearing loss, but the type of device, features, and programming need to be tailored to your specific condition. An audiologist can recommend the best solution based on detailed test results.
Often, no. Many cases of conductive hearing loss are temporary and can be resolved through medication, minor surgery, or removing blockages like earwax. Early treatment helps prevent further complications.
A hearing specialist uses tests like pure-tone audiometry, tympanometry, and ABR/ASSR to evaluate hearing. These tests help determine whether the issue lies in the outer, middle, or inner ear, and how severe the hearing loss is.
Cochlear implants are not necessarily better they serve a different purpose. They’re designed for people with severe or profound hearing loss who don’t benefit from hearing aids. An assessment by an audiologist will help determine which is more suitable for you.
If you’re over 50 or exposed to loud noise regularly, you should have your hearing tested every 1 to 2 years. If you experience sudden hearing changes, ringing in your ears, or difficulty understanding speech, get tested right away.
Yes, especially if infections are frequent or left untreated. Chronic ear infections can damage the middle ear structures and lead to permanent hearing loss if not managed properly.
You can visit The Hearing Centre for a full range of hearing tests, including pure-tone audiometry, tympanometry, and ABR/ASSR. Their expert audiologists offer accurate diagnosis and personalised treatment plans.