How the Different Types of Hearing Loss Show Up on an Audiogram
A beginner-friendly guide to hearing test results and what they say about your hearing
A person reaches to touch an infant's ear
Hearing loss can vary person to person. In some cases, it’s present from birth. In others, it develops gradually. A child who is hard of hearing might struggle to reach speech milestones. Adults might notice they’re turning up the TV more often or feeling tired after socializing. The symptoms and severity often depend on which part of the ear or auditory system is affected.
Hearing loss can be caused by many factors,including age, genetics, noise exposure, illness, or injury. Even something like earwax buildup or fluid in the ear can affect hearing. That’s why diagnosis matters. Audiologists use hearing tests and audiograms to measure how you hear different sounds and volumes. These results help identify the type and level of hearing loss and point to the next steps for treatment.
“The first step is to visit an audiologist for a comprehensive hearing evaluation. Even mild hearing loss can be identified early with a professional test,” says Dr. Reisman, AuD.
The 3 key takeaways
- You can have multiple types of hearing loss — Depending on the cause, you can experience mixed hearing loss rather than one kind.
- There are levels of hearing loss — While profound deafness is complete hearing loss, there are multiple stages leading up to it.
- Hearing loss can be temporary — Depending on the cause, hearing loss may be able to be resolved with medication or surgery. In some cases, though, it may be permanent.
The four types of hearing loss, explained
Hearing loss doesn’t always look the same. There are four main types, each with its own causes, symptoms, and treatment options. Understanding the difference is an important step toward getting the right support.
Sensorineural hearing loss
If you can hear voices but they sound unclear or muffled, especially in noisy places, it might be sensorineural hearing loss. This is the most common type of permanent hearing loss and affects how sound is processed by the inner ear or hearing nerve.
Causes of sensorineural hearing loss
Most often, this type of hearing loss is related to age or long-term noise exposure. But it can also result from head trauma, infections, certain medications, or conditions like Meniere’s disease. Some babies are born with it due to genetic factors or complications during birth.
Symptoms of sensorineural hearing loss
People with sensorineural hearing loss often say that they can hear, but not clearly. Speech may sound muffled, especially in noisy environments. Higher-pitched sounds—like birds, alarms, or children’s voices—can be hard to detect. Tinnitus, or ringing in the ears, is also common.
Treatment for sensorineural hearing loss
This type of hearing loss is typically permanent, but that doesn’t mean it can’t be treated. Hearing aids are the most common solution, and they can be very effective. In more severe cases, cochlear implants may be an option.
“Some might have hearing loss that is mild or situational, and they may manage with strategies or devices like personal amplifiers, OTC devices, or assistive listening devices rather than full hearing aids,” says Dr. Reisman, AuD.
Captioning tools and group-friendly devices can also make communication easier in daily life.
Conductive hearing loss
If sounds seem muffled or like your ears are plugged, you might be dealing with conductive hearing loss. Conductive hearing loss happens when sound can’t pass through the outer or middle ear as it normally would. It’s often caused by something physical — like a blockage or structural issue — and in many cases, it can be temporary or treatable.
Causes of conductive hearing loss
Common causes of conductive hearing loss include:
- Earwax buildup
- Fluid in the middle ear (from colds or infections)
- A hole or damage in the eardrum
- Abnormal bone growth (otosclerosis)
- Objects stuck in the ear canal
- Problems with the bones in the middle ear (ossicles)
Symptoms of conductive hearing loss
Sounds may seem muffled or quieter, but not distorted. People often feel like their ear is plugged or full. You may also hear your own voice more loudly in one ear, or notice hearing loss in the morning that improves throughout the day.
Treatment for conductive hearing loss
In many cases, this type of hearing loss can be reversed. Treatment may involve removing a blockage, treating an ear infection, or using medication. In other cases, minor surgery or hearing aids designed for conductive loss may help.
Mixed hearing loss
If your hearing loss feels inconsistent — like it changes depending on the situation — you could be dealing with mixed hearing loss. This type combines elements of both conductive and sensorineural hearing loss. That means there’s a problem with both sound transmission and the inner ear or hearing nerve.
Causes of mixed hearing loss
This type often occurs when someone with sensorineural hearing loss develops a second issue, like an ear infection or fluid buildup. It can also be caused by trauma, chronic ear conditions, or aging combined with middle ear problems.
Symptoms of mixed hearing loss
People with mixed hearing loss may notice muffled sound, difficulty understanding speech, and ringing in the ears (tinnitus). The symptoms may be more noticeable or seem to fluctuate based on other health factors, noise, or environment.
Treatment for mixed hearing loss
Treatment depends on the cause. Sometimes the conductive part can be treated with medication or surgery, which may improve hearing. The sensorineural portion is usually managed with hearing aids, assistive listening devices, or in some cases, cochlear implants.
Auditory Neuropathy Spectrum disorder (ANSD)
Sometimes you can hear sounds clearly, but your brain has trouble making sense of them. That’s what happens with Auditory Neuropathy Spectrum Disorder (ANSD). Unlike other forms of hearing loss, ANSD affects how sound signals travel along the hearing nerve, not the ear’s ability to detect sound. The ear may detect sound normally, but the brain doesn’t receive those signals in a clear, organized way.
Causes of ANSD hearing loss
ANSD can be caused by damage to the inner hair cells, the hearing nerve, or the connections between them. In infants, it may be linked to premature birth, low oxygen at birth, or other complications in the neonatal period. In older children or adults, it may be connected to genetic conditions, neurological disorders, or auditory nerve damage.
Symptoms of ANSD hearing loss
One of the most common signs of ANSD is difficulty understanding speech, especially in noisy environments. Some people may have normal hearing during a test that checks the ear’s response to sound, but still struggle to follow conversations. Symptoms may include inconsistent hearing, problems with sound clarity, or speech delays in children.
Treatment for ANSD hearing loss
Treatment depends on how severe the symptoms are and how the person responds to sound. Some people benefit from hearing aids or cochlear implants. Others may use assistive listening devices or communication strategies like speech reading or sign language. A hearing test that includes both behavioral and electrophysiological assessments is key to diagnosing ANSD and creating a treatment plan. Because symptoms can vary, ongoing check-ins with your audiologist may help track changes and adjust your treatment plan as needed.
Degrees of hearing loss
Hearing loss can range from mild to profound, depending on how much sound a person can hear. It can affect one ear (unilateral) or both (bilateral), and symptoms might vary between the two. Diagnosis typically starts with a hearing test, or audiogram, which measures how well you hear different pitches and volumes. This helps audiologists determine both the severity and kind of hearing loss — and guides what treatment might be most helpful.
Conclusion
Understanding the different types and degrees of hearing loss is the first step toward finding the right support. While symptoms vary — from muffled sound to full loss in one or both ears — an audiologist can diagnose the cause through a hearing test and recommend options like hearing aids, implants, or assistive tools. Management plans also depend on whether the hearing loss is permanent or temporary, and how it impacts daily life. Conditions like Central Hearing Loss, which involves how the brain processes sound, may need more specialized care. Explore more hearing conditions and what they mean for you.
