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Understanding mixed hearing loss

Mixed hearing loss  is one of three types of hearing loss. Damage to the outer, middle and inner ear simultaneously results in mixed hearing loss. Find out what causes it, the symptoms, and more information on proper prevention and treatment.
What is mixed hearing loss?

A combination of the two

Mixed hearing loss refers to a combination of conductive and sensorineural hearing loss in one or both ears. This means there is damage to both the outer or middle ear (conductive) and the inner ear or auditory nerve (sensorineural). It can result in difficulty hearing both loud sounds, such as fireworks and police sirens, as well as soft sounds, such as whispering and leaves rustling.

Mixed hearing loss often requires a combination of medical and hearing aid treatment.

The illustration below indicates which parts of the ear may be affected when dealing with conductive and sensorineural hearing loss. A combination of the two would indicate a mixed hearing loss.

Book an appointment with one of our hearing centers to get your hearing tested for mixed hearing loss.

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What's causing the problem?

Pinpointing the cause of mixed hearing loss can be tricky. After all, you’re dealing with two types of hearing loss and, as a result, multiple causes. 

Causes of the conductive hearing loss can include blockages, such as earwax build-up or foreign objects, benign tumors, infections or fluid build-up in the middle ear. Common causes of sensorineural hearing loss include loud noise, damage to the hair cells in the inner ear, age, genetics, head trauma, and ototoxic medications.

Signs and symptoms

Recognizing mixed hearing loss

If you are living with mixed hearing loss, you’ll likely have trouble hearing everyday sounds, especially quieter ones. You may experience this in one or both ears. 

Since mixed hearing loss is a combination of two issues, you may also experience several of the following symptoms as well:

  • Pressure, discomfort or pain in the ear

  • Ringing in the ear (tinnitus)

  • Sudden loss of hearing

  • Drainage from the ear

  • Muffled hearing

  • Difficulty hearing speech in crowded places

  • Dizziness or balance issues
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Mixed hearing loss audiogram

Decoding your hearing screening results

Since mixed hearing loss is the result of both a sensorineural and conductive hearing loss, both of these will be present on an audiogram. 

To determine this, the air conduction threshold and bone conduction threshold need to be tested. If a hearing loss is indicated through bone conduction and an air-bone gap (a space between the air and bone conduction threshold) is also present, the audiogram indicates a mixed hearing loss. 

The audiogram below demonstrates what a mixed hearing loss may look like. The red line with the O shows the right ear and the blue one with the X shows the left ear. The < > symbols indicate the bone conduction threshold.

Book an appointment with one of our hearing centers to get your hearing tested for mixed hearing loss.

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More about audiograms
Mixed hearing loss audiogram

Good hearing begins with good health

...and a mindful lifestyle. Mixed hearing loss can have a significant impact on an individual's ability to hear and understand speech and sounds. It's important to understand the causes of mixed hearing loss and take proactive steps to prevent it.

  • Protect your ears from loud noises
    Loud noises, such as concerts, loud music, and industrial or construction noise, can damage your hearing over time. To reduce your risk, it's important to limit exposure to loud noises and wear protective gear, such as earplugs, when necessary.

  • Maintain a healthy lifestyle
    Good health practices, such as not smoking, avoiding certain medications that are known to damage hearing, and managing conditions such as high blood pressure and diabetes, can help protect your hearing.

  • Get regular hearing check-ups
    Regular hearing screenings can detect hearing loss early on, allowing for prompt treatment and reducing the risk of further damage. It's recommended to schedule a regular hearing screening with your Hearing Care Professional to ensure your hearing is in good health.
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Check your hearing consistently

Mixed hearing loss calls for mixed treatment. The causes of your conductive hearing loss may be treatable through medical or surgical intervention, while your sensorineural hearing loss can often be treated with hearing aids. And, with the extreme advances in technology today, treatment is just around the corner. 

Take the first step to healthy hearing by having your hearing checked by one of our Hearing Care Professionals for free.

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Did you know?

Medical history

In 400 BC, Greek physician Hippocrates wrote about different types of hearing loss, including mixed hearing loss. He recommended remedies like earwax removal and avoiding exposure to loud noises. He is considered one of the earliest pioneers in the study of hearing loss, setting the foundation for modern understanding of the condition.
Expert advice

Green your ears

Studies have shown that a diet high in fruits, vegetables, whole grains, and nuts can help support good hearing health. The vitamins and minerals found in these foods have been linked to reduced risk of hearing loss and improved overall ear health.

Mixed hearing loss: FAQ

Is mixed hearing loss permanent?

How common is mixed hearing loss?

What does a mixed hearing loss audiogram look like?

Do hearing aids help with mixed hearing loss?

Next steps to better hearing


How to treat your hearing loss

Hearing health is one of the building blocks of a happy life. If you can understand how your hearing works and what you can do to protect it, you won't just be doing your ears a favor, you'll be boosting your overall health and well-being, too.
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Why take action on your hearing loss?

Hearing loss not only affects how you hear, but how well your brain is able to function. From protecting your physical and mental well-being to improving your career outlooks, your hearing plays an essential role in it all. With HearUSA by your side, you’ll have all the tools you need to stop the effects of hearing loss and start hearing better today.
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