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Mixed Hearing Loss

Learn causes and symptoms of mixed hearing loss, and the available treatments.

What is mixed hearing loss?

Mixed hearing loss is a type of hearing difficulty that is a combination of conductive and sensorineural hearing loss.

  • Conductive hearing loss: Hearing loss caused by issues with the outer or middle ear, in which sound is not conducted effectively. 
  • Sensorineural hearing loss: Hearing loss caused by a problem with the inner ear or the hearing nerve pathway that connects the inner ear to the brain that typically comes with age.

When there are problems with the outer- or middle ear's ability to conduct sound waves and with the inner ear and/or the auditory nerve's ability to process sound data and pass it along to the brain, treatments need to address both issues in order to be effective and help people hear to their best ability. 

Types of mixed hearing loss

There are a few medical terms that can be used to describe specific types of mixed hearing loss and put a finer point on a diagnosis. If the condition only occurs on one side of the patient, it is known as unilateral mixed hearing loss. If it presents on both sides, it is known as bilateral mixed hearing loss. The severity of mixed hearing loss can vary greatly, ranging from mild all the way down to profound hearing loss. 

If the severity of mixed hearing loss is the same in both ears, it is described as symmetrical. If it differs in each ear, it is known as asymmetrical

Mixed hearing loss can also be described in terms of the frequencies at which hearing is most affected. High-frequency hearing loss means that it's difficult to distinguish higher-pitched sounds, such as children's voices or birds singing. Low-frequency hearing loss refers to challenges hearing sounds with lower pitches, like thunder or dogs barking. 

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Mixed hearing loss symptoms

The most noticeable symptom of mixed hearing loss is a decreased ability to hear sounds, especially faint sounds. However, because mixed hearing loss is a combination of conductive and sensorineural hearing loss, symptoms of either or both conditions may also be present at the same time. 

Symptoms of sensorineural hearing loss: Muffled hearing, difficulty understanding conversation amidst background noise, sudden loss of hearing, ringing in the ears and vertigo or balance issues. 

Symptoms of conductive hearing loss: Sudden onset of hearing loss, pain or discomfort, feeling of pressure in the ear and potential draining of fluid in the ear. 

What causes mixed hearing loss?

Because it is a combination of sensorineural and conductive hearing loss, anything that causes those two conditions can lead to mixed hearing loss. Here are some of the leading causes: 

  • Aging: The lead cause of hearing loss is aging, also known as presbycusis.
  • Illness: Some conditions, such as heart disease, dementia, certain thyroid conditions or Meniere's Disease, can lead to tinnitus and hearing loss.
  • Drugs: Ototoxic medications, such as certain antibiotics, anticancer drugs and anti-inflammatory drugs, can cause symptoms of hearing loss.
  • Head or ear trauma: A traumatic brain injury, hole in the eardrum or other traumatic damage to the middle ear can cause hearing loss. 
  • Buildup of earwax in the ear canal: Excess earwax can block the ear canal and prevent the conduction of sound waves, causing hearing loss.
  • Fluid in the middle ear: Sometimes caused by allergies, infection or congestion, fluid can build up behind the eardrum and block the auditory tube in your ear. 

Because these symptoms are shared among multiple types of hearing loss, it can be difficult to determine the exact source or cause. A hearing specialist from Miracle-Ear may be able to assess your symptoms and find a solution to treat your mixed hearing loss. 


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If you experience any off the possible signs of mixed hearing loss, be sure to schedule a free hearing exam with a Miracle-Ear hearing specialist.

Mixed hearing loss diagnosis

The most common way to diagnose mixed hearing loss is an audiometric hearing evaluation, in combination with examination of the ears, nose, throat and neck, and a detailed patient history. Your hearing care specialist uses the physical information to identify possible physiological issues, while audiometry examines the severity of hearing loss in detail. 

An audiometric evaluation is conducted by a hearing specialist on a device known as an audiometer. The result of this test, called an audiogram, is interpreted by the hearing specialist to determine the type and severity of hearing loss a patient is experiencing. A mixed hearing loss audiogram will illustrate the combination of factors affecting your ability to hear. For example, a person may have age-related hearing loss AND excessive build-up of earwax, which, when combined, result in a mixed hearing loss. Your audiologist will review your results with you to discuss in detail the causes of what you're experiencing and next steps for treatment.  

Mixed hearing loss treatment

The conductive element of mixed hearing loss, depending on the underlying cause, can often be treated with medical or surgical procedures. The sensorineural portion of mixed hearing loss, however, generally is not treatable with medical or surgical procedures, though there are some rare exceptions. 

Most often, mixed hearing loss is treated with a combination of medical or surgical intervention, and sound amplification devices like hearing aids. However, every case of mixed hearing loss is unique. To find a solution that addresses your individual case while meeting your lifestyle needs, make an appointment with a hearing specialist from Miracle-Ear to discuss your options. 


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With personalized professional guidance and a well-considered plan of intervention, it is possible to minimize the impact of mixed hearing loss on your day-to-day life. Find a Miracle-Ear location near you today to discover your hearing support solutions.

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