There are three types of hearing loss: conductive, sensorineural, and mixed. To understand the types of hearing loss, it is easiest to think about the parts of that they affect. Conductive hearing loss affects the outer and middle ear, while sensorineural hearing loss is located in the inner ear. Mixed hearing loss affects various parts of the ear.

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model of the ear to show the auditory process

Hearing is the fastest sense we have – it is faster than seeing. Indeed, light moves faster than sound, so that should preclude that seeing is faster. However, we must take into consideration the amount of time it takes for our brains to register information, and our auditory system works faster than our optical system.

Our outer ear picks up sound waves that travel through our ear canal to the eardrum. When sound waves hit the ear drum, a vibration is caused. These vibrations are sent to the malleus, incus, and stapes, the three tiny bones of the middle ear. These three bones are responsible for amplifying and increasing sound vibrations, which are then sent to the cochlea, a snail-shaped, fluid-filled structure located in the inner ear. Here, the vibrations cause the liquid inside the cochlea to ripple, which are detected by the inner ear hair cells. Inner ear hair cells move along with the ripples, causing electric signals that travel to the brain via the auditory nerve. Here in th brain, the auditory process is complete, with our understanding and recognition of the sound.

sound waves


When it comes to conductive hearing loss, the condition occurs due to issues with the outer ear, the ear canal, and the eardrum. These are all parts of the outer and middle ear. Conductive hearing loss is more of an issue of physical blockage than sensorineural hearing loss (which is caused by issues with the inner ear, particularly the inner ear hair cells).

Conductive hearing loss occurs when sound waves are physically unable to pass through the middle ear and into the inner ear. With this type of hearing loss, much of the sound is lost before it even has time to reach the hair cells or brain for processing. Causes of conductive hearing loss include: excess earwax buildup, otitis externa (infection or irritation of the outer ear), otitis media, barotrauma (caused by shifts in air pressure), otosclerosis (a birth defect that affects the ear bones), ear infections, tumor growth in the middle ear, fluid buildup or a punctured eardrum.

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With conductive hearing loss, people may experience sounds as “muffled” or “faint.” They may also struggle to identify and hear sounds at lower frequencies. For adults with acquired hearing loss, conductive hearing loss may occur gradually, over a long period of time. It may be caused by respiratory infections, impacted earwax, or injury to the outer or middle ear. Many people wait an average of seven years from the time they first experience changes in their hearing abilities to the time they decide to seek treatment. However, conductive hearing loss is not common amongst adults with acquired hearing loss. Usually, older people experience presbycusis or noise-induced hearing loss, both of which are types of sensorineural hearing loss, affecting the inner ear.

Conductive hearing loss may occur more frequently among children, who are either born with congenital hearing conditions or are afflicted with otitis media (ear infections). Children are more susceptible to ear infections due to the size of their Eustachian tubes which are narrow in younger children and may lead to fluid buildup. For congenital hearing loss, conductive hearing loss is identified through newborn hearing screenings.


Conductive hearing loss is identified through a hearing test, as well as an examination of the ear, nose, and throat area. An otoscope may be used to examine the middle ear for earwax buildup or injury to the area. A comprehensive hearing test, which includes tympanometry and audiometry, will provide the degree, configure, and type of hearing loss experienced by the individual.

While hearing aids are the most common treatment for hearing loss, if the cause of hearing loss is due to earwax, injury, tumor, or other medical conditions, then treating those related issues may alleviate the problem.