Which type of hearing loss involves both conductive and sensorineural components?

• A. Sensorineural hearing loss
• B. Auditory neuropathy spectrum disorder
• C. Mixed hearing loss
• D. Conductive hearing loss

Answer: (C)

Mixed hearing loss occurs when both the conductive pathway (outer or middle ear) and the sensorineural pathway (inner ear or auditory nerve) are affected. On an audiogram, you’d see elevated air-conduction thresholds and also elevated bone-conduction thresholds, often with an air–bone gap indicating a conductive contribution plus additional sensorineural involvement. This combination distinguishes it from a purely conductive loss (normal bone conduction with reduced air conduction) and a purely sensorineural loss (reduced bone conduction with little or no air–bone gap). Auditory neuropathy spectrum disorder involves neural timing issues rather than a clear conductive problem, so it doesn’t represent a mix of conductive and sensorineural components.