Identification of the Type of Hearing Loss Based on the Patient's Description

 

Types of hearing loss:

(1) conductive: lesions of the external (cerumen, etc.) or middle (otitis media, otosclerosis, etc.) ear

(2) sensorineural: lesions to the cochlea, auditory division of the acoustic nerve, or both

(3) central: lesions of the central auditory pathways (cochlear and dorsal olivary nuclear complexes, inferior colliculi, medial geniculate bodies, auditory cortex in the temporal lobes, and interconnecting afferent and efferent fiber tracts.

 

Feature	Conductive	Sensori-neural	Central
helped by loud speech	yes	no	no
helped by a quiet background	no	yes	yes
may be unilateral	yes	yes	no
affects certain frequencies only	no	yes	no

 

Conductive hearing loss:

(1) loud speech can be readily understood

(2) patients can hear speech in a noisy background better than in a quiet background

 

Sensorineural hearing loss:

(1) the hearing levels for different frequencies are usually unequal

(2) patients may have difficulty hearing speech if there is background noise present

(3) patients may be annoyed by loud speech

 

Central hearing loss:

(1) hearing of pure tones not impaired

(2) speech understood if it is clearly spoken in a quiet environment

(3) comprehension markedly deteriorates if there is background noise or competing messages