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Types and Degrees of Hearing Loss: Sensorineural, Conductive & Mixed

Writer: Hearing Solutions
Hearing Solutions
2 days ago
9 min read
Types and degrees of hearing loss explained on an audiogram, Professional Hearing Solutions Islamabad
Quick answer: There are three main types of hearing loss: conductive (sound is blocked in the outer or middle ear, often medically treatable), sensorineural (damage to the inner ear or hearing nerve, usually permanent and helped by hearing aids) and mixed (both). Degree is graded from mild to profound using the audiogram. A diagnostic hearing test tells you which type and degree you have.

Reviewed and updated on 26 September 2026 by the Professional Hearing Solutions audiology team, Islamabad & Rawalpindi.


What are the main types of hearing loss?

Hearing loss is classed by where the problem sits: conductive (outer or middle ear), sensorineural (inner ear or nerve) or mixed (both). The type decides whether medical treatment, a hearing aid, or both is the right route.

Sound travels through the ear canal, vibrates the eardrum and the three tiny middle-ear bones, and reaches the cochlea in the inner ear, where hair cells turn it into nerve signals for the brain. A problem anywhere along that path reduces hearing, but the location changes everything about treatment. At Professional Hearing Solutions, an authorised Signia hearing aid dealer serving Islamabad and Rawalpindi since 1999, the first job of every hearing assessment is to find out where the problem is, not just how much hearing is missing. Our types of hearing loss page gives a short overview; this guide goes deeper.

Types of hearing loss at a glance

Type

Where the problem is

Common causes

Typical treatment

Do hearing aids help?

Conductive

Outer ear canal, eardrum or middle-ear bones

Wax impaction, ear infection, fluid (glue ear), perforated eardrum, otosclerosis

Often medical or surgical: wax removal, treating infection, grommets, eardrum or bone surgery

Yes, when medical treatment is not possible or not wanted; results are often very good

Sensorineural

Cochlea (inner ear) or hearing nerve

Ageing, noise exposure, ototoxic medicines, genetics, meningitis, sudden idiopathic loss

Usually permanent; managed with hearing aids, and cochlear implant assessment for severe to profound loss

Yes, the main treatment for most people

Mixed

Both the middle ear and the inner ear

For example long-standing chronic ear infection plus age-related change

Treat the conductive part medically where possible, then fit hearing aids for the rest

Yes, often needing more power or a well-sealed fit

Retrocochlear / neural (less common)

Hearing nerve or brain pathways

Acoustic neuroma, auditory neuropathy

ENT and imaging first; management is individual

Sometimes; results vary and need specialist input


What is sensorineural hearing loss, and can it be cured?

Sensorineural hearing loss comes from damaged hair cells in the cochlea or from the hearing nerve. In most cases it is permanent, but hearing aids fitted to your audiogram can restore much of the lost audibility and clarity.

This is by far the most common type we see in adults. Age-related hearing loss (presbycusis) typically begins in the high pitches, so people hear voices but miss consonants: 'shop' and 'chop' sound alike, and women's and children's voices become harder to follow. Noise damage has a similar high-pitch pattern, often with a characteristic dip around 4000 Hz on the audiogram, and frequently comes with tinnitus.

Because the damage is in the inner ear, there is no tablet, drop or surgery that reliably restores it. Be wary of anyone offering herbal cures for nerve deafness. What works is amplification that is shaped precisely to your hearing, which is why PHS programmes Signia devices in genuine Connexx software against your own audiogram. The Signia hearing aid range covers mild to profound sensorineural loss in several styles.


What is conductive hearing loss, and when is it treatable?

Conductive hearing loss means sound cannot pass properly through the ear canal or middle ear. Many causes, such as wax, infection and fluid, are treatable by an ENT doctor, so medical assessment comes before any hearing aid.

On the audiogram, conductive loss shows as normal or near-normal bone-conduction thresholds with poorer air-conduction thresholds: the air-bone gap. Tympanometry usually adds a clue, for example a flat Type B trace when there is fluid behind the eardrum. In Pakistan, chronic ear discharge from long-standing middle-ear infection and perforated eardrums are still common causes, as is glue ear in children after repeated colds.

Hearing aids are an excellent option when surgery is not advised, has not worked, or the patient prefers not to have it. People with a discharging ear need medical treatment first, and the fitting may need a vented or open style so the ear stays healthy. Your audiologist and ENT specialist should work together here.


What is mixed hearing loss?

Mixed hearing loss is a combination of a conductive problem and sensorineural damage in the same ear. The conductive part may be treatable; the sensorineural part is usually managed with hearing aids.

A typical example is an older adult who has had a perforated eardrum since childhood and now also has age-related inner-ear loss. On the audiogram both air and bone thresholds are lowered, with a gap between them. Treating the middle-ear component first can reduce how much power the hearing aid needs and improve comfort. Mixed losses often need more gain than the numbers alone suggest, so careful verification and fine-tuning matter.


What are the degrees of hearing loss (mild, moderate, severe, profound)?

Degree describes how loud sound must be before you hear it, measured in decibels hearing level (dB HL). A commonly used classification runs from normal (up to 25 dB HL) through mild, moderate, moderately severe and severe, to profound (91 dB HL and above).

The table below uses commonly used WHO/ASHA-style bands, based on the pure tone average across the main speech pitches. The WHO's 2021 grading uses slightly different cut-offs, so reports from different centres may label the same numbers differently. Degree can also vary across pitches in one ear; many people have mild loss in the low pitches and severe loss in the high pitches. Our hearing loss levels page summarises what each level means.

Commonly used degrees of hearing loss (WHO/ASHA-style bands)

Degree

Hearing level (dB HL)

What you notice

Usual hearing aid need

Normal

Up to 25

Hears soft speech

None; monitor if symptoms exist

Mild

26 to 40

Misses soft or distant speech, struggles in groups

Often beneficial, especially for work and social life

Moderate

41 to 55

Asks for repetition, TV loud, conversation tiring

Clearly recommended

Moderately severe

56 to 70

Needs raised voices; groups very hard

Strongly recommended; RIC or BTE with adequate power

Severe

71 to 90

Hears only loud speech close by

Power or super-power BTE; custom ear moulds

Profound

91 and above

May perceive only very loud sounds

Power aids plus cochlear implant assessment; speech and lip-reading support

If you want to understand the O and X symbols and the air-bone gap on your own report, see our guide on how to read your audiogram and hearing test results.


What causes hearing loss in Pakistan?

The most common causes are ageing, noise exposure, middle-ear infections, ototoxic medicines and inherited hearing loss, which is more frequent where cousin marriage is common. Many are preventable or at least slowed with early action.

  • Ageing (presbycusis): gradual, both ears, high pitches first, usually noticed after 55 to 60.

  • Noise: generators, factory and workshop noise, heavy traffic, loud wedding sound systems, earphones at high volume, and aerial firing. Wear earplugs around sustained loud noise.

  • Ear infections: chronic discharging ears and perforations, often from untreated childhood infections; glue ear in young children.

  • Ototoxic medicines: certain injectable antibiotics (aminoglycosides, including some used in tuberculosis treatment), some chemotherapy drugs such as cisplatin, and high-dose loop diuretics. Report any new hearing change or tinnitus to your doctor during treatment; never stop a prescribed medicine on your own.

  • Genetic and congenital causes: inherited hearing loss, congenital infections, premature birth, severe newborn jaundice and meningitis.

  • Other conditions: Meniere's disease, otosclerosis, head injury and, less commonly, acoustic neuroma.

According to the WHO, more than 1.5 billion people worldwide live with some degree of hearing loss, and around 430 million need rehabilitation. Many of them are never tested. If a child in your family is affected, read our guide to child hearing loss in Pakistan; if ringing is your main complaint, see our tinnitus guide.


Is sudden hearing loss an emergency?

Yes. Sudden sensorineural hearing loss, a noticeable drop in hearing in one ear over hours to three days, is an emergency. See an ENT specialist the same or next day, because treatment works best when started early.

Red flag: waking up with a blocked or dead-feeling ear that is not explained by a cold or wax, especially with new tinnitus or dizziness, needs urgent ENT review. Treatment, often with steroids prescribed by the doctor, has the best chance of helping when started within days. Do not wait to see if it settles, and do not buy a hearing aid first.

Other situations that need an ENT doctor before hearing aids: ear discharge or bleeding, ear pain, vertigo, hearing loss or tinnitus in one ear only (which may need an MRI scan), pulsatile tinnitus, facial weakness, and hearing change after head injury or blast exposure. A written audiogram from PHS helps your ENT specialist make decisions quickly.


Behra pan ka ilaaj: hearing aid or ENT route?

If the loss is conductive or sudden, see an ENT first. If it is stable sensorineural or mixed loss, hearing aids fitted to your audiogram are the proven treatment.

Choosing the right route

Your situation

Best first step

Gradual loss in both ears, no pain or discharge

Hearing test, then hearing aid consultation

Blocked ear after a cold, flight or swimming

Hearing test with tympanometry; ENT if fluid or infection

Sudden loss, one-sided loss, vertigo or discharge

Urgent ENT review, then audiology

Stable loss after ear surgery or long-standing perforation

Hearing aid assessment with ENT clearance

Severe to profound loss with poor benefit from aids

Audiology plus cochlear implant assessment

PHS dispenses German original Signia devices with the full manufacturer warranty, plus Rexton, Audio Service and ReSound, and openly explains the Singapore-manufactured budget option. We do not dispense Chinese copies. Our hearing aid price guide for Pakistan explains the options by style and budget. To find out your own type and degree, book a hearing assessment at Blue Area, Islamabad or Saidpur Road, Rawalpindi. PHS has 400+ Google reviews with a 4.9-star average.


Frequently Asked Questions

What are the three types of hearing loss?

The three main types are conductive, sensorineural and mixed. Conductive loss is a blockage or problem in the ear canal or middle ear and is often medically treatable. Sensorineural loss is damage to the inner ear or hearing nerve and is usually permanent, managed with hearing aids. Mixed loss combines both. A hearing test with bone conduction and tympanometry tells them apart.

Which type of hearing loss is most common?

In adults, sensorineural hearing loss is the most common type, mainly due to ageing and noise exposure. It usually affects both ears and starts in the high pitches, so people hear voices but miss words. In young children, temporary conductive loss from glue ear after colds is very common and should be checked if a child seems inattentive or speech is delayed.

Can sensorineural hearing loss be reversed?

Usually not. Once the inner-ear hair cells are damaged they do not regrow, and no medicine or herbal product reliably restores them. The exception is sudden sensorineural hearing loss, where urgent ENT treatment started within days can sometimes help recovery. For stable sensorineural loss, well-programmed hearing aids are the proven way to restore audibility and clarity.

What does moderate hearing loss mean?

In a commonly used classification, moderate hearing loss means your hearing thresholds average between 41 and 55 dB HL. You may hear that people are speaking but often ask them to repeat, turn the television up and find family gatherings tiring. Hearing aids are clearly recommended at this level, and most people do well with receiver-in-canal or behind-the-ear styles.

Is 40 percent hearing loss the same as 40 dB?

No. Audiologists measure hearing in decibels (dB HL), not percentages. Percentage figures are sometimes calculated for disability or legal forms, but they do not describe what you actually hear. A 40 dB HL average falls at the edge of mild and moderate loss. Ask for your audiogram and the degree for each ear rather than a single percentage.

Kya behra pan ka ilaaj mumkin hai?

It depends on the type. Conductive hearing loss (wax, infection, fluid, some eardrum and bone problems) can often be treated by an ENT doctor. Sensorineural behra pan is usually permanent, but hearing aids fitted to the audiogram can make speech clear again. Sudden hearing loss is an emergency and needs an ENT the same or next day.

Do I need hearing aids for mild hearing loss?

Many people with mild loss benefit, especially if they work in meetings, teach, or spend time in noisy family settings. Mild loss makes listening tiring and causes missed words that others notice before you do. The decision depends on your audiogram, speech scores and daily needs. A hearing assessment lets you hear the difference a correctly programmed device makes before you decide.

Book Your Visit at Professional Hearing Solutions

Professional Hearing Solutions has served patients in Islamabad and Rawalpindi since 1999 as an authorised Signia hearing aid dealer, with 400+ Google reviews and a 4.9-star average. Book a hearing assessment or a hearing aid consultation at either clinic.

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