As a doctor of audiology, an integral part of my practice includes identifying different types of hearing loss and their causes through various assessments and examinations. Once I have identified the type and cause, I am better able to apply the proper therapy or treatment to correct the hearing loss issue, restoring my patients’ hearing completely or in part. Because I believe in providing the Madison County community with a higher level of hearing health awareness, I am providing a short guide defining the two types of hearing loss and describing what an audiologist can do to help.

Conductive Hearing Loss

Conductive hearing loss can be a temporary or ongoing condition. The distinguishing characteristic of conductive hearing loss is that its primary cause relates to some sort of blockage or malformation in the outer or middle ear, which obstructs or prevents sound waves from completing their journey through the hearing pathway to the inner ear. Conductive hearing loss usually involves issues with the ear canal, eardrum, or the small bones in the middle ear.


Symptoms reported by patients who have a conductive hearing loss often include the sensation that sounds, even their own voice, seem to be far off in the distance, unclear, or muffled. Additional symptoms include sensations of increased pressure or pain in the ears, increased earwax buildup, and frequent sore throats from fluid drainage.

Common Causes

Varieties of causes contribute to conductive hearing loss. Temporary or simple causes may include:

• Earwax Buildup
• Swelling or Fluid from an Infection
• A Growth or Tumor in the Ear Canal

Complicated causes, requiring extensive treatment, might include:

• Perforation or Scarring of the Eardrum
• Otosclerosis. Abnormal growth or stiffening of the bones in the middle ear impeding the performance of these conductive structures

Treatment Options

The majority of conductive hearing loss conditions are easily corrected using medications or minor surgical procedures. Complex cases may require middle ear transplants or hearing aids to enhance or restore hearing.

Sensorineural Hearing Loss

Sensorineural hearing loss relates to sound wave transmission issues located in the inner ear. This form of hearing loss results from damage to either the hair-like nerve endings located within the cochlea or damage to the auditory nerve, which transmits sound signals to the brain for processing into identifiable sound.


Symptoms most often associated with sensorineural hearing loss include muffled sound, including your own voice, tinnitus (a continuous ringing, buzzing, or hissing sensation in the ears), or a reduced capacity to comprehend speech when visual cues are absent.

Common Causes

Various causes leading to this type of hearing loss include:

• Traumatic Injury
• Excessive Noise Exposure
• Viral Infections (measles or mumps)
• Ototoxic Drugs
• Meningitis
• Diabetes
• Stroke
• High Fever
• Meniere’s disease
• Acoustic Tumors
• Heredity
• Age Deterioration

Treatment Options

Hearing aids are the most common treatment option for sensorineural hearing loss in aging adults. Due to its success in treating children and young adults, a cochlear implant provides another viable treatment option.

Mixed Hearing Loss

There are only two types of hearing loss, but cases, where both types contribute to hearing impairment, are also possible. Mixed hearing loss includes causes and symptoms of both sensorineural and conductive hearing loss. These cases often accompany traumatic injury or infection. Causes and symptoms often present in a vice versa configuration in which symptoms of conductive hearing loss have a sensorineural cause or symptoms of sensorineural hearing loss are the result of a conductive cause. Mixed hearing loss treatments include surgical procedures, medications, and hearing aids targeted to correct each specific cause.

Audiologists have the expertise and equipment to identify the specific causes of all types of hearing loss in order to prescribe the most effective treatment or treatments for full or partial restoration of hearing. My team and I at Alabama Hearing Associates are passionate about providing top-level hearing health care to our patients in Huntsville and Madison County. Contact us to learn more about the various types of hearing loss or to set up an appointment in one of our North Alabama or Tennessee Valley locations.

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Dr. Jan Liles

Dr. Liles earned her bachelor’s degree from the University of Montevallo and her master’s degree from the University of Alabama. From 1991 to 2001, she worked with two ENT medical practices and initiated one of the first newborn hearing screening programs in the state. In 2002, she was awarded a doctorate in audiology from the University of Florida. Dr. Liles and her longtime best friend, Dr. Sheehy, founded Alabama Hearing Associates in January 2002.
    Real World Adjustments

    Your hearing loss didn't occur overnight, so it will take some time to adjust to the hearing aids. Your patience and persistence will be well worth it.

    AHA Continued Care & Coverage Plan

    $395 Per Year

    Hearing Aids are not a quick fix, and better hearing is truly a journey.

    Our "Continued Care & Coverage Plan" allows you to have the continued support of a hearing expert throughout the year.


    • Dedicated team of hearing care experts at your service
    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance evaluation
    • 100% moisture removal by Redux and cleaning
    • Two tele-audiology appointments
    • Bi-annual hearing aid software update and reprogramming
    • Hearing aid supplies (stock receivers, batteries, domes, and filters)
    • Access to our "speed of light" repair specialists within 2 business days
    • $100 discount on any out-of-warranty factory repairs
    Assessing Outcomes

    To ensure the most success with your hearing devices, we measure the benefits of amplification at the end of your adjustment period—some of the surveys and tests included in the “Connect 365” Functional Hearing Assessment will be repeated to evaluate progress, quality of life, and patient satisfaction with the hearing aids. 

    Wireless Connections

    Most hearing aids automatically come with wireless streaming from smartphones and it has been a lifesaver for those that are working remotely and spending hours on teleconferences. As for other wireless accessories, the two most popular solutions are a small microphone used in less-than-ideal listening environments and a TV streamer that streams the TV’s sound directly into your ears—which can be a lifesaver when watching British TV shows or during football season. If your audiologist believes they would be beneficial for you, they will discuss your options and demonstrate the device in the office.

    Orientation, Counseling, and Follow-up

    Dr. Cliff (the creator of the Best Practice Pro Network) said it best:

    “Having a detailed orientation can dramatically improve how much success you have with hearing treatment.  Counseling & Follow-up care can also ensure that you have success for years to come.  Regular visits to a hearing care provider who spends the time to discuss treatment related information and who will maintain your devices is extremely important.”

    During the orientation, your provider will give you the tools you need to be a successful hearing aid user. Everyone has different learning styles and we want to make sure whatever works best for you is what’s used. After the 75 day adjustment period, routine checkups are necessary to maintain the hearing aids and to ensure optimal hearing healthcare. 

    What Is Real-Ear Measurement?

    Real-ear measurement (REM) is how an audiologist knows that hearing aids are working the way they should in each patient’s ears.

    Ears are as unique as a fingerprint. Because of this, every ear will collect sounds differently.

    Even if I had two patients with the exact same hearing loss and hearing aids, there’s almost no chance the hearing aids would be programmed the same way.

    How do I know my new hearing aids are working properly?

    Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. The most sensitive quality control measure is something called Electroacoustic Analysis. We complete EAA on every new set of hearing aids, before delivery of repaired devices, and on an annual basis.

    Prescription Hearing Technology with a Methodical Plan

    Our community understands better than most what can be achieved when you combine technology with human intelligence and persistence. It is much the same with hearing technology.

    The latest prescription hearing aid technology is incredibly powerful, offering stellar sound quality and performance. Wireless connections allow phone calls, music and television to stream directly to your hearing aids for exceptional clarity.

    But hearing aids do not fit and program themselves! For best outcomes, you also need the human touch and expertise provided by our Doctors of Audiology.

    A Comprehensive12-Step Functional Hearing Assessment

    If you struggle to understand conversations in social situations, restaurants, or other noisy environments, you do not need to schedule a basic hearing test. You certainly don’t need to schedule a “free” hearing screening or online hearing test.

    You need to schedule a “Connect 365” Functional Hearing Assessment at Alabama Hearing Associates!

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    Comprehensive 5-Year treatment plan with premium prescription hearing aid technology

    If you want premium “out of this world” technology and the highest level of service and expert support, our All-Inclusive treatment plan is the right investment for you.

    The All-Inclusive treatment plan offers long-term value for your on-the-go lifestyle, providing everything you need to connect with family and friends for years to come.


    • Stellar  prescription hearing devices from top manufacturer (rechargeable option available)

    • Wireless accessory included at no charge

    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance valutaion

    • Bi-annual hearing aid software update and reprogramming

    • Same day diagnosis and in-office repair during weekdays for devices dropped off before 3:00 p.m.

    • 5-Year full-service repair warranty

    • Unlimited remote hearing aid adjustments

    • 100% moisture removal by Redux and cleaning

    • Hearing aid supplies (stock receivers, batteries, domes and filters)

    • $1000 contribution towards purchase of upgraded technology within 48 months

    • 3-Year replacement warranty for loss or damage (no deductible)

    • Dedicated team of hearing care experts at your service

    • Unlimited teleaudiology appointments

    • Access to our “speed of light” repair specialists

    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.