Let’s take an in-depth look at the three types of hearing loss:
Conductive Hearing Loss
Conductive hearing loss is due to problems with the ear canal, ear drum, or middle ear and its little bones (the malleus, incus, and stapes).
Causes of Conductive Hearing Loss
- Malformation of outer ear, ear canal, or middle ear structure
- Fluid in the middle ear from colds
- Ear infection (otitis media – an infection of the middle ear in which an accumulation of fluid may interfere with the movement of the eardrum and ossicles)
- Poor Eustachian tube function
- Perforated eardrum
- Benign tumors
- Impacted earwax
- Infection in the ear canal
- Foreign object in the ear
- Otosclerosis (a hereditary disorder in which a bony growth forms around a small bone in the middle ear, preventing it from vibrating when stimulated by sound; read more at NIDCD
Treatments for Conductive Hearing Loss
- Surgery may correct conductive hearing loss that is due to the congenital absence of ear canal or failure of the ear canal to be open at birth, congenital absence, malformation, or dysfunction of the middle ear structures (i.e. from head trauma), and otosclerosis
- Amplification may be a solution with the use of a bone-conduction hearing aid, or a surgically implanted, osseointegrated device (for example, the Baha or Ponto System), or a conventional hearing aid, depending on the status of the hearing nerve.
- Antibiotic or antifungal medications are used to treat chronic ear infections, or chronic middle fluid. Tumors usually require surgery.
Sensorineural Hearing Loss
Sensorineural hearing loss (SNHL) is due to problems of the inner ear, also known as nerve-related hearing loss.
Causes of Sensorineural Hearing Loss
Treatment of Sensorineural Hearing Loss
- Sudden sensorineural hearing loss (SSHL), presumed to be of viral origin, is an otologic emergency that is medically treated with corticosteroids.
- Corticosteroids may also be used to reduce cochlea hair cell swelling and inflammation after exposure to loud noise.
- Sensorineural hearing loss can occur from head trauma or abrupt changes in air pressure (e.g., airplane descent), which can cause inner ear fluid compartment rupture or leakage, which can be toxic to the inner ear. There has been variable success with emergency surgery when this happens.
- Bilateral progressive hearing loss over several months, also diagnosed as autoimmune inner ear disease, is managed medically with long-term corticosteroids and sometimes with drug therapy. Autoimmune inner ear disease is when the body’s immune system misdirects its defenses against the inner ear structures to cause damage in this part of the body.
- Fluctuating sensorineural hearing loss may be from unknown cause or associated with Ménière’s disease. Symptoms of Meniere’s disease are hearing loss, tinnitus (ringing in the ears), and vertigo. Ménière’s disease may be treated medically with a low-sodium diet, diuretics, and corticosteroids. If the vertigo is not medically controlled, then various surgical procedures are used to eliminate the vertigo.
- Sensorineural hearing loss from disease in the central nervous system may respond to medical management for the specific disease affecting the nervous system. For example, hearing loss secondary to multiple sclerosis may be reversed with treatment for multiple sclerosis.
- Irreversible sensorineural hearing loss, the most common form of hearing loss, may be managed with hearing aids. When hearing aids are not enough, this type of hearing loss can be surgically treated with cochlear implants.
Mixed Hearing Loss
Mixed hearing loss is caused by a combination of conductive damage in the outer or middle ear and sensorineural damage in the inner ear (cochlea) or auditory nerve.
Treatments for Mixed Hearing Loss
Audiologists recommend taking care of the conductive component first. There have been times when the addition of the conductive component made the person a better hearing aid candidate, by flattening out the audiogram for example, while the underlying sensorineural component presented a high-frequency loss. However, the emphasis would still be on treating medically what can be treated. Generally, you would expect positive results.