Understanding Your Hearing Loss Diagnosis

Nearly 50 million people in the United States alone have some form of hearing loss. Most cases can be grouped into one of three classifications, but everyone experiences hearing loss differently.

If you or a loved one have recently received a hearing loss diagnosis, you may be wondering how to interpret that diagnosis.

In this article, the Ability Central team explains the most important parts of a hearing loss diagnosis. We answer questions like:

* What are the three categories of hearing loss?

* How is hearing loss measured?

* What other testing might be required after a hearing loss diagnosis?

* Where can I get more information about hearing loss?

What are the three categories of hearing loss?

Hearing loss is generally grouped into one of three categories:

Sensorineural hearing loss
Conductive hearing loss
Mixed hearing loss

Sensorineural hearing loss

Sensorineural hearing loss typically happens due to loud noise, loud work environments, or aging. In these cases, hearing loss comes from damage to the tiny hair cells inside the cochlea, the part of the ear that converts sounds into electrical impulses.

For someone with normal hearing, the cochlea’s small hair cells move and flex in response to sound. Using those responses, the cochlea converts sound signals into electrical impulses, which then pass through the auditory nerve to the brain. If those hair cells don’t function properly, you may experience hearing loss.

Causes of sensorineural hearing loss include:

Chronic exposure to loud noise, like frequent concerts or working on a construction site, without proper ear protection
Single, extremely loud sounds, like an explosion
Genetic conditions like Usher syndrome
Viruses or severe infections
Aging

Some forms of sensorineural hearing loss go away with treatment of an underlying condition like an infection. More commonly, however, doctors treat sensorineural hearing loss with hearing aids.

Doctors like audiologists or ear, nose, and throat doctors (ENTs) can help you figure out the level of your hearing loss and make device recommendations based on your needs.

Conductive hearing loss

Conductive hearing loss, also called mechanical hearing loss, happens when something prevents sound transmission between the outer, middle, and inner ear. Usually, this is because of a blockage, like earwax buildup or inflammation.

With conductive hearing loss, nothing is wrong with your cochlea or auditory nerve. Instead, noises can’t reach the parts of your inner ear that process sound.

Some causes of conductive hearing loss include:

Earwax buildup
Drainage or fluid in the ear
Injury to the ear canal that causes inflammation (swelling), bleeding, or scabbing
A hole or tear in the eardrum (also called a “perforated eardrum” or “burst eardrum”)
Swimmer’s ear, or frequent ear infections after water exposure
Abnormal ear structure at birth
A foreign blockage (like beads or bugs)
Non-cancerous bone growths or tumors
Damage to the bones in the middle ear

Treatment for conductive hearing loss usually involves treatment of the underlying cause, although some people with conductive hearing loss may benefit from hearing aids.

Mixed hearing loss

Mixed hearing loss involves a combination of both conductive hearing loss and sensorineural hearing loss.

How is hearing loss measured?

Hearing tests measure how well your ears process sound, which is measured in decibels.

There are six main “levels” of hearing loss:

Normal hearing (no more than 25 decibels of hearing loss). Someone with normal hearing can typically hear people breathing, insects buzzing, and leaves rustling.
Mild hearing loss (between 26 and 40 decibels). Someone with mild hearing loss means you won’t be able to hear people whispering, electronics running, or rain on the roof.
Moderate hearing loss (between 41 and 55 decibels). Someone with moderate hearing loss won’t be able to hear people working in a quiet office, rain falling, or coffee brewing.
Moderate to severe hearing loss (between 56 and 70 decibels). Someone with moderate to severe hearing loss won’t hear people talking at an average volume, a dishwasher running, or people laughing.
Severe hearing loss (between 71 and 90 decibels). Someone with severe hearing loss can’t hear doorbells or telephones ringing, traffic noises, or a vacuum cleaner.
Profound hearing loss (between 91 and 100 decibels). Someone with profound hearing loss can’t hear someone shouting, a lawnmower, or a motorcycle, or they may not hear anything at all. Someone with no hearing whatsoever is said to have “profound hearing loss” or “profound deafness.” They may also be described as “profoundly deaf.”

A hearing loss diagnosis will typically be a percentage: for example, a 20% loss would be considered mild or moderate, while an 80% loss could be severe or profound.

What other testing might be required after a hearing loss diagnosis?

If you’ve received a hearing loss diagnosis, you’ve probably already had a hearing test with your family doctor or an audiologist. Other tests may be needed to determine what kind of hearing loss you have, or to look for other conditions linked to hearing loss.

Standard hearing tests include:

Pure tone testing, in which you listen for beeps or other sounds and press a button or raise your hand when you hear them
Whisper tests, in which an examiner stands behind you and whispers numbers, letters, or phrases for you to repeat
Tests for hearing loss besides hearing tests include:
Bone conduction testing, which uses vibration to test whether a hearing problem is conductive, sensorineural, or mixed.
MRIs and CT scans to look at the brain and other parts of the body.
Otoscopic inspection, when a doctor inspects the inside of your ear with specialized equipment.
Immittance screening, a series of tests that check the tympanic membrane, which separates the middle ear from the outer ear.
Acoustic reflex testing, which tests the reactions of muscles in the inner ear using a small probe.
Acoustic reflex decay testing, used if acoustic reflex testing discovers abnormalities. This test follows the same structure as acoustic reflex testing, but the probe sits in the ear with suspected damage while sounds play in the other ear.

Where can I get more information about hearing loss?

For more information on hearing loss, check out these resources from Ability Central:

Resources on hearing loss

For more information about conditions linked to hearing loss, see: