Mixed hearing loss

Laura James, Professional Services Manager and Hearing Aid Dispenser at The Hearing Care Partnership. Laura James  |  Published 09 January 2025  | Updated 29 January 2025  | 4 mins read

Diagram of an ear illustrating the origin of mixed hearing loss, highlighting both conductive and sensorineural pathways.

Mixed hearing loss is trouble hearing in both the middle or outer ear (also known as conductive hearing loss) and the inner ear (also known as sensorineural hearing loss). Causes of mixed hearing loss can vary, but usually result from a combination of factors affecting the different parts of the ear. If you’ve noticed a change in your hearing loss or have recently been diagnosed with hearing loss, read on to learn more about mixed hearing loss, how it’s treated, and the causes.

What is mixed hearing loss?

There are three main types of hearing loss: sensorineural, conductive, and mixed, which is a combination of the first two types.

Sensorineural hearing loss occurs when damage or trauma affects the auditory nerve or the delicate structures inside your inner ear and is often not treatable. Conductive hearing loss occurs when something prevents sound from reaching your middle or inner ear. This can be something curable, like a build-up of earwax, or it could be due to malformed bone structures inside your ear. Mixed hearing loss is a hearing problem that combines both sensorineural and conductive loss and can range from mild to profound. 

What are the symptoms of mixed hearing loss?

The symptoms of mixed hearing loss are the same as any other type of hearing loss. You may notice difficulty understanding speech, need the sound on the TV or radio to be higher than normal, or miss high-pitched noises like alarms.

The most common mixed hearing loss symptoms include:

  • Difficulty hearing speech – especially in loud environments
  • Difficulty hearing soft or low sounds
  • Needing to turn up the volume on devices, TVs, and radios
  • Tinnitus
  • Ear pain
  • Vertigo

If you or someone close to you has experienced these symptoms and suspects they have hearing loss, it’s important to book a hearing assessment as soon as possible. The Hearing Care Partnership offers free hearing tests, so book one in today.

What causes mixed hearing loss?

Older woman with wrinkles and gray hair, cupping her hands behind her ears as if straining to hear.

As mixed hearing loss is a combination of both sensorineural and conductive hearing loss, there are many different potential causes of hearing loss.

Common sensorineural hearing loss causes include:

  • Presbycusis – also known as age-related hearing loss and a natural part of ageing. 
  • Viruses or infections.
  • Head trauma.
  • Damage to your auditory nerve.
  • Loud noises – either sudden sounds like explosions or gradually over time, such as when working with heavy machinery. 
A woman holding her ear in pain.

Common conductive hearing loss causes include:

So, for example, you could have hearing loss caused by loud noises but also contract an ear infection, resulting in a diagnosis of mixed hearing loss. 

How is mixed hearing loss diagnosed?

Mixed hearing loss is diagnosed by your audiologist, who will perform a range of different tests to determine the exact cause of your hearing loss. They will perform an audiometry test (to determine how well you hear certain pitches), along with an examination of your nose, ears, neck, and throat. By cross-referencing this information with your patient history, they can help to determine your exact type of hearing loss as well as the severity. 

Can mixed hearing loss be treated?

Treatment will depend on the type of hearing loss you have. Many types of hearing loss are temporary and can be treated to restore some, the majority, or all of your hearing (for example, treating an ear infection will help clear hearing loss associated with it). However, there are some types of hearing loss, such as most sensorineural hearing loss, that are permanent and can not be treated. If the hearing loss you have is permanent, you will be offered management options such as hearing aids.

Takeaway

Mixed hearing loss is one of 3 different types of hearing loss. It is a combination of sensorineural and conductive hearing loss and, depending on the causes, may or may not be permanent. The type of hearing loss and the causes of it will determine the treatment and management options you’re offered. Thankfully, there are plenty of options to help you get your quality of life back if you do have mixed hearing loss.

Mixed hearing loss FAQs

It depends on the cause. As mixed hearing loss is a combination of sensorineural and conductive hearing loss, you may or may not get your hearing back. Most types of sensorineural hearing loss are permanent. However, many conductive hearing loss causes can be treated to restore part or the majority of your hearing.

There are many types of hearing aids on the market and the type you choose depends on your lifestyle and severity of hearing loss. Long gone are the days of one-size-fits-all hearing aids your grandparents wore – there are lots of discreet options with exciting tech (such as Bluetooth connectivity) to choose from.

Yes. You can have different levels of hearing loss in each ear, and they can also have different causes.

Mixed hearing loss is the least common type of hearing loss after sensorineural and conductive hearing loss.