How do you treat mixed hearing loss?

Professionals often categorise hearing loss as either sensorineural or conductive. Sensorineural hearing loss occurs when there is a problem with the inner ear or auditory nerve. Typically, it affects the tiny hair-like structures in the cochlear which provide the information required for sending auditory neural impulses to the brain.

Conductive hearing loss refers to forms of hearing loss where sound can’t reach the inner ear. Usually, it results from trauma, obstruction or conditions such as otosclerosis.

However, patients can have both forms of hearing loss at the same time, referred to as “mixed hearing loss.” Since mixed hearing loss is a combination of conditions, it often requires multiple different treatments.

What are the signs of mixed hearing loss?

People with mixed hearing loss do not necessarily experience more symptoms than those with just sensorineural or conductive hearing loss alone. In all types of hearing loss, the lack of sound perception can vary from very mild to profound. For some mixed hearing loss patients, the condition is a slight inconvenience while, for others, it is life-changing.

People with mixed hearing loss experience symptoms of both conductive and sensorineural hearing loss.

Typical sensorineural hearing loss symptoms include:

1) Tinnitus – a ringing and buzzing in the ears
2) Difficulty hearing certain sounds in regular speech, such as consonants
3) Hearing loss in both ears (sometimes referred to as “bilateral hearing loss”)
4) Problems hearing high-pitched sounds
5) Difficulty hearing what people are saying in loud environments. Noisy rooms where there are many conversations going on at once can be particularly problematic.

Conductive hearing loss tends to have different symptoms. These include:

1) Hearing loss in one ear (also called “unilateral hearing loss)
2) A feeling of pressure or pain in one or both ears
3) The sensation that your voice sounds different or too loud when you speak
4) Odours or discharge from the ear canal

In many cases, conductive hearing loss results from impacted ear wax. Tiny hairs inside the ear canal can no longer clear the ear wax and it continues to build up, causing an obstruction.

People with mixed hearing loss experience a combination of symptoms from both these categories. For instance, they might have problems hearing what people are saying in a noisy room and a feeling of fullness in their ears.

What causes mixed hearing loss?

Mixed hearing loss has multiple etiologies. These could include tumours, build-up of ear wax, infections, excessive bone growth, foreign objects stuck in the ear, trauma, damage to the cochlear and middle-ear fluid. Audiologists have sophisticated tools that can home in on the precise causes and identify them.

How do you treat mixed hearing loss?

How audiologists and hearing health professionals treat mixed hearing loss depends on what is causing it. Usually, they will treat the conductive and sensorineural aspects separately.

First, audiologists will diagnose hearing loss with an audiogram. Then they will conduct additional tests to determine the source of the hearing loss. If you have multiple causes of hearing loss, they will diagnose mixed hearing loss.

There are several ways to treat mixed hearing loss.

For instance, if you have excessive wax in your ears, hearing health professionals offer various safe techniques to remove it. Some use special tools that scoop excess ear wax out of your ears manually. Others use micro-suction devices to pull cerumen out without causing any damage to the eardrum. On occasion, they may also use wax-clearing solutions, similar to those that you can buy over the counter.

If you have fused bones in the middle ear causing conductive hearing loss (also called otosclerosis), your audiologist may recommend surgery. Here, they make an incision in your ear canal and then cut the bones apart and replace a section with them with plastic or metal material. These operations are 80 to 90 per cent successful.

Audiologists will treat the sensorineural aspect of mixed hearing loss with hearing aids. Assistive hearing devices amplify incoming sounds from the environment with the help of a speaker placed close to the eardrum. These stimulate the biological apparatus of the ear more than regular unamplified sounds, making it easier for the brain to interpret.

Lastly, your audiologist may recommend that you use a cochlear implant. These devices stimulate the cochlear nerve, enhancing hearing for some patients.