Types of Hearing Loss Explained: Sensorineural, Conductive, and Mixed-What Your Audiogram Reveals

You catch bits of a conversation at dinner, but miss the punchline. The TV volume creeps up, yet dialogue still sounds mumbled. These subtle changes often signal a shift in how you hear, but they rarely tell you why it is happening. Understanding your hearing starts with looking beyond the volume knob. At 3 Senses ENT & Dental Clinic, we use comprehensive testing to pinpoint the exact nature of your hearing loss. Whether the issue lies in your ear canal or the auditory nerve, our audiogram results guide us to the right solution for you.

Also Read: Types of Ear Infections in Adults: Middle vs Outer Ear Explained

What Your Audiogram Actually Tells Us

An audiogram acts as a map of your hearing health. It plots the softest sounds you can hear across different pitches, revealing patterns that point to specific types of hearing loss.

• Pitch and Volume: The graph shows low bass tones on one side and high treble tones on the other. We mark the lowest volume you detect for each pitch.
• Air Conduction: We test how well you hear sounds traveling through the air into your ear canal. This measures the entire hearing system from outer ear to brain.
• Bone Conduction: A device placed behind your ear sends vibrations directly to the inner ear. This bypasses the eardrum and shows us how well your nerve endings function.
• The Gap Matters: Comparing air and bone conduction results helps us distinguish between a blockage in the ear (conductive) and permanent nerve damage (sensorineural).
• Speech Clarity: Beyond beeps, we test how well you understand words at a comfortable volume. This confirms if your hearing loss affects clarity or just loudness.

The Comprehensive Testing Approach at 3 Senses

We rely on a suite of advanced diagnostic tools to ensure every diagnosis is precise. Dr. Shikha Mishra leads our audiology team, interpreting these results to build your care plan.

• Pure Tone Audiometry: This standard test creates your audiogram, establishing your hearing thresholds for air and bone conduction.
• Impedance Audiometry: We use this to check the health of your middle ear. It measures eardrum movement and reflex responses to loud sounds, ruling out fluid or stiffness.
• SISI Test: The Short Increment Sensitivity Index helps us identify if the problem originates in the cochlea (inner ear) by testing your ability to detect tiny volume changes.
• Tone Decay Test: This evaluates how well your auditory nerve sustains a signal over time, helping us spot nerve fatigue or retro-cochlear issues.
• OAE (Otoacoustic Emissions): We measure the echo produced by healthy inner ear hair cells to confirm cochlear function, especially useful in difficult-to-test patients.

Sensorineural Hearing Loss: When the Inner Ear Struggles

Sensorineural Hearing Loss is the most common permanent type we see. It occurs when the delicate hair cells in the cochlea or the auditory nerve itself sustain damage.

• Audiogram Pattern: Both air and bone conduction thresholds show similar levels of hearing loss. There is no significant gap between the two lines on the graph.
• Common Causes: Aging and long-term exposure to loud noise are frequent triggers. Viral infections, certain medications, and genetics also play a role.​
• Symptoms: You typically hear people speaking, but words sound mumbled or slurred. High-pitched sounds like “s” and “f” become hard to distinguish, especially in background noise.​
• Treatment Path: Since we cannot repair damaged hair cells medically, we focus on rehabilitation. Digital hearing aids programmed to your specific loss restore clarity. In profound cases, we may discuss cochlear implant options.

Also Read: What is Called for a Temporary Hearing Loss?

Conductive Hearing Loss: When Sound Meets a Blockage

Conductive Hearing Loss happens when sound waves fail to reach the inner ear efficiently. The problem lies in the outer or middle ear, acting like a physical barrier to sound.

• Audiogram Pattern: Bone conduction thresholds remain normal (the inner ear works fine), but air conduction shows hearing loss. This creates a visible “air-bone gap” on the chart.​
• Common Causes: Earwax buildup, fluid behind the eardrum, ear infections, or a perforated eardrum often cause this type. Stiffness in the middle ear bones (otosclerosis) is another factor.​
• Symptoms: Sounds feel muffled or faint, similar to wearing earplugs. You might hear your own voice sound louder or “hollow” (occlusion effect).​
• Treatment Path: Many conductive issues are medically or surgically treatable. We might clear a blockage, treat an infection, or recommend a procedure. If medical treatment doesn’t fully restore hearing, specific hearing aids or bone-conduction devices work well.

Mixed Hearing Loss: Facing Two Issues at Once

Sometimes, a patient experiences Mixed Hearing Loss, a combination of both sensorineural and conductive components affecting the same ear.

• Audiogram Pattern: Both air and bone conduction lines show hearing loss, but the air conduction is significantly worse. The gap between them confirms the mixed nature.​
• Common Scenario: A person with age-related nerve hearing loss (sensorineural) might also develop a middle ear infection (conductive). Alternatively, severe otosclerosis can eventually affect the inner ear.​
• Symptoms: You face a double challenge—volume is reduced due to the blockage, and clarity is compromised by nerve damage.
• Treatment Path: We tackle the conductive component first, often through medical management. Once the middle ear is healthy, we address the remaining sensorineural loss with hearing aids or rehabilitation.​

Interpreting Your Results for a Better Life

Understanding your diagnosis empowers you to take the right steps. We break down the technical terms into a plan that fits your lifestyle.

• Degree of Loss: We categorize your hearing from mild to profound. This tells us how much amplification or support you need for daily communication.​
• Configuration: The shape of your audiogram—whether it slopes or stays flat—guides us in programming hearing aids to boost the specific pitches you miss.​
• Speech Scores: Knowing your speech discrimination percentage helps manage expectations. It tells us how much clarity hearing aids will likely restore.
• Personalized Plan: We don’t just hand you a report. We explain how your specific types of hearing loss affect your work, social life, and safety, then design a solution that bridges those gaps.

Why Expert Diagnostics Matter

Accurate treatment relies entirely on precise testing. Attempting to treat hearing loss without distinguishing between conductive and sensorineural causes leads to poor outcomes.

• Equipment Quality: Our clinic uses calibrated, clinical-grade audiometers and impedance analyzers to ensure every decibel measured is accurate.
• Professional Expertise: Dr. Shikha Mishra and our audiology team bring specialized knowledge in interpreting complex patterns, ensuring no detail is overlooked.
• Holistic Care: Because we are an ENT and Dental clinic, we can address underlying medical causes (like infections) in-house while managing the rehabilitation side, offering a seamless care experience.

Also Read: Who Benefits Most from Cochlear Implants? Candidacy and Next Steps

Ready to Understand Your Hearing?

Don’t let muffled conversations or guessing games become your normal. At 3 Senses ENT & Dental Clinic, Dr. Shikha Mishra and our expert team use precise diagnostics to map your hearing health clearly. Whether you need medical treatment or advanced digital hearing aids, we guide you to the right solution.

Book your comprehensive hearing assessment today. Call us at +91 88262 62607 or visit us at G 240, Sushant Lok 2, near Hong Kong Bazaar, Gurgaon-122011. Schedule online and take the first step toward clarity.

FAQs

1. What are the 4 types of hearing loss?

The four main types of hearing loss include Conductive Hearing Loss (outer/middle ear blockage), Sensorineural Hearing Loss (inner ear/nerve damage), Mixed Hearing Loss (both components), and Auditory Neuropathy Spectrum Disorder (sound reaches ear but brain doesn’t process it clearly).​

2. What are the five types of hearing loss?

Some classifications expand to five types of hearing loss: Conductive Hearing Loss, Sensorineural Hearing Loss, Mixed Hearing Loss, Auditory Neuropathy Spectrum Disorder, and Central Hearing Loss (brain processing issues beyond the ear).​

3. What are the 4 levels of hearing loss?

The four standard levels (degrees) of hearing loss are: Mild (26-40 dB, misses soft speech), Moderate (41-55 dB, struggles with normal conversation), Severe (56-70 dB, hears only loud speech), and Profound (>70 dB, misses most speech).​

4. What is category 3 hearing loss?

Category 3 hearing loss typically refers to Severe hearing loss (71-90 dB range in some Indian disability grading systems), where patients hear loud sounds but miss conversational speech without amplification.