What Is Mixed Hearing Loss?

Published August 22nd, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Chris Riley

Hearing loss affects millions of people around the world.

While age is a strong predictor of hearing loss among adults, it can also come from heredity, injury, or disease. 

The truth is hearing loss can affect anyone, regardless of age. Generally, hearing loss is in two categories: conductive and sensorineural hearing loss.

The type of hearing loss will determine the type of treatment a person seeks. 

There are cases when both conductive and sensorineural hearing loss are both present — referred to as mixed hearing loss.

Your hearing health is important; read on for some helpful information. 

How Common Is Hearing Loss?

Hearing loss can occur when a part of the auditory system isn’t functioning as it should.

This could result from damage to the auditory nerve or issues that affect the outer, middle, or inner ear. 

According to the World Health Organization, over five percent of the world’s population requires rehabilitation to address hearing loss issues.

By 2050, nearly two and a half billion people may have hearing loss. 

Hearing loss or hearing troubles affects roughly 15 percent of American adults, which is approximately 37.5 million people. But hearing loss doesn’t affect adults only. 

According to hearing loss statistics provided by the CDC, approximately two to three out of every 1,000 children in the United States are born with some degree of hearing loss. 

How Is Mixed Hearing Loss Defined?

Hearing loss is put into two main categories: conductive and sensorineural hearing loss.

However, the third category of hearing loss is also known as mixed hearing loss

In short, this type of hearing loss combines conductive and sensorineural hearing loss.

In this type of hearing loss, blockage or physical damage to the outer, middle, inner ear, or nerve pathways can make age-related hearing damage or genetic hearing loss even worse. 

The causes of mixed hearing loss can vary widely.

Generally, some sort of sensorineural hearing is already present, and conductive hearing loss develops in conjunction with it, making it mixed hearing loss. Typical causes of mixed hearing loss include:

  • Genetic factors
  • Age-related hearing loss
  • Noise induced hearing loss 
  • Trauma to head 
  • Ear infections
  • Earwax impaction
  • Use of certain medications

Conductive and Sensorineural Hearing Loss

As stated above, mixed hearing loss combines conductive and sensorineural hearing loss.

Each case of mixed hearing loss is different since the factors contributing to conductive and sensorineural hearing loss vary greatly. 

Conductive Hearing Loss

Hearing loss caused by sounds unable to pass through the outer and middle ear is called conductive hearing loss.

It is typically the result of obstruction or trauma.

This type of hearing loss makes it difficult to hear soft sounds. The hearing loss could be temporary or permanent. 

Common causes of conductive hearing loss include:

  • Head trauma causing fractures to the small bones in the middle ear, disrupting normal hearing. 
  • Earwax (cerumen) getting stuck or impacted in the ear canal, obstructing sound. 
  • Obstruction by small items stuck in the ear canal, typically in small children. 
  • Infections, such as swimmer’s ear, causing temporary conductive hearing loss from fluid buildup in the middle ear.

Treatment for conductive hearing loss varies. For example, a healthcare provider can extract earwax obstructions and prescribe medications to combat infections.

Sensorineural Hearing Loss

This type of hearing loss is considered the most common.

Although sudden sensorineural hearing loss can happen, it is typically the result of normal aging. 

In medical terms, it is known simply as age-related hearing loss (presbycusis), affecting roughly one-third of adults between 65 to 70. 

Less common causes of sensorineural hearing loss can include:

  • Side effects from ototoxic medications.
  • Disease and illness like mumps, Meniere’s disease, or diabetes.

Another type of hearing loss to mention is noise-induced hearing loss (NIHL), which is triggered by an extremely loud noise.

A one-time exposure to loud noises can result in tinnitus and hearing loss if the damage to the cochlea is severe. 

What Are the Degrees of Hearing Loss?

Hearing loss can affect individuals in different ways, depending on the cause of the hearing loss.

Hearing loss can happen suddenly or progressively over time. It can occur in one ear (unilateral) or both ears (bilateral). 

The degree of hearing loss can also vary from person to person, ranging from mild to profound, and can even differ in each ear. 

Typically, the degree of hearing loss is measured in decibels (dB) which are confirmed through a hearing exam with an audiologist. 

  • A mild degree of hearing loss ranges from 26 to 40 dB, making soft sounds hard to hear.
  • Moderate and moderately severe degree of hearing loss is in between 41 to 70 dB, making normal speech sounds hard to discern. 
  • Severe hearing loss and profound hearing loss range from 71 dB or more, where little to no speech sounds are present; only very loud sounds can be discerned. 

What Are the Signs and Symptoms of Mixed Hearing Loss?

The most obvious symptom of mixed hearing loss is a decreased ability to hear or discern common sounds.

This is especially true for faint or soft sounds. 

However, since mixed hearing loss is a combination of conductive and sensorineural hearing loss, the symptoms may vary depending on the cause.

For example, someone with age-related hearing loss may get an ear infection, causing pain and further hearing loss due to fluid build-up. 

The symptoms of mixed hearing loss can occur in one ear (unilateral) or both (bilateral). 

How Is Mixed Hearing Loss Diagnosed?

Since mixed hearing loss is a combination of two different types of hearing loss, it is important to seek professional medical advice for a proper diagnosis. 

The most common way to diagnose mixed hearing loss is through a hearing test performed by a hearing specialist.

In addition to a hearing exam, there is usually an examination of the ears, nose, and throat to detect potential structural issues. 

It is important to note that if hearing loss results from trauma, it is important to seek emergency medical attention immediately. 

Treatment Options for Mixed Hearing Loss

While there are treatment options available to address mixed hearing loss, it will depend on the cause of the hearing loss.

Generally, the conductive portion of the mixed hearing loss can be treated through medications or surgery, depending on the cause and severity. 

Since it is typically a result of age-related factors, the sensorineural portion of mixed hearing loss is not generally treatable through medications. 

While surgical interventions are sometimes necessary, the most common treatment option for sensorineural hearing loss is hearing aids that use amplification of noises to the eardrum or some type of implant device (like a cochlear implant). 

When it comes to mixed hearing loss, the best plan is to seek medical advice from a hearing professional who can properly diagnose the hearing issues and offer a treatment plan. 

Conclusion

Millions of people around the world are affected by hearing loss.

While hearing loss is more commonly a result of the normal aging process, it can impact adults and children. 

Conductive and sensorineural are the two main categories of hearing loss, with sensorineural hearing loss being the most common due to age-related hearing loss. 

Mixed hearing loss is considered a third category of hearing loss.

Mixed hearing loss is a combination of conductive and sensorineural hearing loss. When it comes to mixed hearing loss, it is important to consult a hearing specialist for treatment options. 

References, Studies and Sources:

Deafness and hearing loss| WHO

Quick Statistics About Hearing | NIDCD

Mixed Hearing Loss | ASHA

Conductive Hearing Loss | ASHA

Hearing loss in old age (presbycusis) | Healthy Hearin

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