Your audiologist just explained your hearing test results and mentioned you have "sensorineural hearing loss" or maybe "conductive hearing loss." The terms sound technical, and you nodded along, but as you left the office, you wondered: What's the actual difference? And why does it matter for my treatment?
Here's the practical answer: the type of hearing loss you have determines which treatments will work and what outcomes you can expect. Conductive hearing loss often responds to medical or surgical treatment because the problem is mechanical—something is blocking or disrupting sound transmission. Sensorineural hearing loss is usually permanent because it involves damage to delicate inner ear structures that can't regenerate, though hearing aids and other devices can help you hear better.
The Core Difference
Conductive hearing loss happens when sound can't efficiently travel through your outer or middle ear to reach the inner ear. Think of it like trying to hear through a closed window—the sound waves are blocked or muffled before they reach the part of your ear that processes sound. Common causes include earwax buildup, ear infections with fluid, eardrum perforations, or problems with the tiny bones in your middle ear.
Sensorineural hearing loss occurs when there's damage to the inner ear (cochlea) or the auditory nerve that carries sound signals to your brain. The sound waves reach your inner ear just fine, but the damaged hair cells or nerves can't properly convert those sound waves into electrical signals your brain can understand. This type is most often caused by aging, noise exposure, or certain medications.
How Your Audiologist Knows the Difference
Your hearing test includes both air conduction (testing through headphones or earphones) and bone conduction (testing with a small vibrator placed behind your ear). When air conduction is worse than bone conduction, it indicates conductive hearing loss—something is blocking sound from getting through. When both are equally affected, it indicates sensorineural hearing loss—the inner ear or nerve is the problem.
Quick Comparison
| Feature | Conductive | Sensorineural |
|---|---|---|
| Where the problem is | Outer or middle ear | Inner ear or auditory nerve |
| How sounds feel | Muffled, quieter, like listening underwater | Unclear, distorted, especially in noise |
| Common causes | Ear infections, earwax, perforated eardrum, fluid | Aging, noise exposure, genetics, certain medications |
| Is it reversible? | Often yes—with medical or surgical treatment | Usually no—permanent but manageable |
| Treatment approach | Address underlying cause (surgery, medication, removal of blockage) | Hearing aids, cochlear implants, or assistive devices |
Why the Type Matters for Your Treatment
Understanding which type of hearing loss you have shapes your entire treatment plan and what you can expect. If you have conductive hearing loss from chronic ear infections, your ENT might recommend ear tubes or surgery to fix the underlying problem—potentially restoring your hearing to normal. If you have sensorineural hearing loss from years of noise exposure, the focus shifts to hearing aids or cochlear implants that amplify and clarify sound since the damage itself can't be reversed.
Mixed hearing loss is when you have both types—perhaps age-related inner ear damage plus chronic ear infections. Treatment addresses both components: medical care for the conductive part and hearing devices for the sensorineural part.
What This Means for You
If your hearing loss is conductive, ask your provider about the underlying cause and whether it's treatable. Many people with conductive loss can have significant improvement or complete restoration of hearing with appropriate medical or surgical intervention. If your hearing loss is sensorineural, know that while the damage is permanent, modern hearing aids and cochlear implants help most people hear significantly better and stay connected to conversations and activities they value.
The most important thing is getting an accurate diagnosis through comprehensive hearing testing. Once you know which type of hearing loss you have, you and your audiologist can create a treatment plan that addresses your specific situation.
Common Questions
Yes—this is called mixed hearing loss. You might have age-related sensorineural hearing loss plus fluid in your middle ear from allergies, for example. Treatment addresses both components.
Sometimes—because conductive loss typically makes sounds quieter but doesn't distort them, increasing volume can help. However, treating the underlying cause is better than just making things louder, especially if the cause is treatable.
While the inner ear damage can't be reversed, you're far from stuck. Modern hearing aids can make a dramatic difference in your ability to hear and understand speech. For severe cases, cochlear implants bypass the damaged hair cells entirely and directly stimulate the auditory nerve.
You can't reliably determine the type on your own—you need proper testing. Symptoms can overlap, and what feels like conductive loss might actually be sensorineural, or vice versa. A comprehensive hearing evaluation with both air and bone conduction testing is the only way to accurately diagnose the type.
The Bottom Line
Knowing whether you have conductive or sensorineural hearing loss isn't just medical terminology—it's essential information that guides your entire treatment path. Conductive loss often has reversible causes that respond to medical or surgical treatment. Sensorineural loss is typically permanent but highly manageable with the right devices. Getting an accurate diagnosis through comprehensive testing is the first step toward hearing your best.
Next Steps: Understand Your Hearing
Learn more about hearing loss types or find a provider to get a comprehensive evaluation.