Conductive vs. Sensorineural Hearing Loss: Key Differences

Conductive Hearing Loss

• Cause: Blockage or damage in outer/middle ear (earwax, otitis media, perforated eardrum, ossicle issues).
• Sound transmission: Sound waves partially/completely blocked from reaching inner ear; overall volume reduced.
• Speech understanding: Clarity usually unaffected; difficulty hearing faint sounds but can understand speech in quiet.
• Rinne test: Air conduction > bone conduction.
• Weber test: Sound lateralizes to affected ear (louder there).

Sensorineural Hearing Loss

• Cause: Damage to inner ear (cochlea, hair cells, auditory nerve) from aging, noise, genetics, medications, infections, etc.
• Sound perception: Impaired reception/transmission of sound signals; reduced loudness and difficulty understanding speech, especially in noise.
• Speech understanding: Clarity often affected; hard to understand conversational speech at normal volume.
• Rinne test: Bone conduction > air conduction.
• Weber test: Sound lateralizes to better‑hearing ear.

Management

Conductive loss is often medically/surgically treatable. Sensorineural loss is usually permanent, managed with hearing aids or cochlear implants.