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How Do I Know Whether I Have Conductive or Sensorineural Hearing Loss?

Hearing Loss5 July 2023Updated 13 July 20243 minutes read
The Short Answer

The definitive answer comes from a simple hearing test that compares air conduction with bone conduction. Conductive loss — a blockage in the outer or middle ear — produces an "air-bone gap"; sensorineural loss, involving the inner ear or hearing nerve, affects both equally. Symptoms give clues, but only an audiogram confirms which type you have.

At a Glance

Key Takeaways

  • Sensorineural loss stems from damage to the auditory nerve or the inner ear's tiny hair cells (stereocilia).
  • Conductive loss is an obstruction in the outer ear, ear canal or middle ear that reduces sound levels.
  • Conductive loss mainly affects loudness (turning up volume helps); sensorineural affects clarity — hearing but not understanding.
  • Sensorineural is usually permanent and aided by devices; conductive is often treatable with medicine or surgery.

The ear is an essential yet delicate organ. It helps us not only hear but interpret sounds in our environment. Hearing involves changing sound waves in the air into electrical signals that are then transmitted to the brain. Hearing loss happens when one or more parts of the ear, hearing part of the brain or nerves coming from the ear are not working as they should.

Common types of hearing loss

Sensorineural hearing loss is the damage of either the auditory nerve or the stereocilia (tiny hair-like cells). The sound still reaches the inner ear, but the damaged hair cells or auditory nerve cannot convert and pass it on to the brain clearly. Most people with sensorineural tend to hear though not clearly.

Conductive hearing loss occurs when there is an obstruction to the outer, ear canal or middle ear. The sounds levels tend to reduce as they reach the cochlea making soft sounds a struggle to hear.

Sensorineural versus conductive hearing loss

One of the ways to tell whether you have either of the two is by knowing what triggers each.

Sensorineural is a permanent hearing loss that has several causes:

  • Presbycusis (ageing)
  • Genetic syndrome
  • Exposure to loud noises
  • Birth defects
  • Different types of illnesses such as diabetes
  • Ototoxic drugs
  • Infections
  • Neurological conditions like stroke

Conductive hearing loss may be permanent or temporary subject to the cause. Causes of obstructions in the outer ear are wax impaction, microtia, exostoses (bone-like protrusions), foreign bodies and stenosis.

Other causes that may prevent sound from being conducted to the inner ear include:

  • Breach in the eardrum caused by an injury
  • Otitis media (many episodes of ear infection)
  • Ossicular chain discontinuity (a broken connection between bones)
  • Otosclerosis (abnormal bone growth near the middle ear)
  • Tumours and Tympanoclerosis (thickening of the eardrum)

Symptoms of conductive and sensorineural hearing loss

Sensorineural hearing loss is about the loudness and clarity of a sound. One can know if they have sensorineural if they hear but cannot understand, they have difficulties hearing high-pitched sounds or listening in noisy places. Other symptoms are difficulty following conversations when one or two people speak, straining with certain speech sounds and ringing or buzzing in the ear.

Conductive hearing loss is more about the loudness of the sound and not clarity. In most cases, turning up volumes improves the hearing. Pain in one or both ears, a sensation of pressure in one or both ears and foul odour from the ear canal are the common symptoms. Other symptoms include feeling that one’s voice is louder or different and having difficulties with phone conversations.

Treatment options for sensorineural and conductive hearing loss

Though the damaged hair cells do not regenerate, patients with sensorineural hearing loss patients can benefit from cochlear implants, assistive listening devices and power-hearing aids.

Conductive hearing loss is treatable with medical or surgical treatment. However, hearing loss caused by Ossicular chain separation or stenosis of the ear canal are permanent conditions. Such instances require hearing aids or bone-anchored hearing aids (Baha) devices.

Knowing the symptoms and the causes of conductive and sensorineural hearing loss makes you aware of your condition. However, to understand the state of your hearing, it is vital to undertake hearing tests like air conduction tests or bone conduction testing.

Patient Questions

Frequently Asked Questions

How do I know if I have conductive or sensorineural hearing loss?

You cannot reliably diagnose the type at home; the definitive test is an audiogram that compares air conduction with bone conduction. Conductive loss shows a gap between the two thresholds (an 'air-bone gap'), whereas sensorineural loss affects both roughly equally. A qualified audiologist can run the test and confirm which type you have.

What is the main difference between conductive and sensorineural hearing loss?

Conductive hearing loss is a blockage or fault in the outer or middle ear — such as earwax, fluid from an infection, or a perforated eardrum — that stops sound reaching the inner ear. Sensorineural hearing loss involves the inner ear's hair cells or the hearing nerve, so sound arrives but is not converted into a clear signal for the brain. As a result, conductive loss mainly makes sounds quieter, while sensorineural loss also makes them less clear.

Can conductive or sensorineural hearing loss be cured?

Conductive hearing loss is often treatable — depending on the cause, removing earwax, treating an infection, or minor surgery can restore hearing. Sensorineural hearing loss is usually permanent because damaged inner-ear hair cells do not regrow, but hearing aids or cochlear implants can help significantly. An audiologist can recommend the right option based on your test results.

When should I see a professional about hearing loss?

See a GP or audiologist if your hearing is gradually getting worse, or if you notice ringing, pressure or trouble following conversations. Treat sudden hearing loss in one or both ears as urgent and seek medical help straight away, as early treatment can improve recovery. A hearing test is quick and painless, and it is the only way to confirm the type and degree of loss.

References

Sources

  1. NHSHearing loss
  2. NIDCD (US National Institute on Deafness and Other Communication Disorders)How Do We Hear?
  3. NIDCD (US National Institute on Deafness and Other Communication Disorders)Age-Related Hearing Loss (Presbycusis)
  4. StatPearls, NCBI Bookshelf (National Library of Medicine)Conductive Hearing Loss
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