Bilateral Hearing Loss: Types, Causes, and Treatments

Losing your ability to hear certain sounds is part of getting older.

Still, if you feel your hearing loss is happening at a rate much faster than your biological birthday should allow, you could have bilateral hearing loss. 

Together, we’ll talk about the structures that help us hear, the causes of hearing loss and deafness, and the treatment options available to help you hear better.

We’ll also talk about prevention and how to eliminate some of the most common causes of permanent hearing loss.

If you’ve suffered hearing loss, there are groundbreaking methods of treatment that can help you hear more clearly, and pick up lost sound.

How Does Hearing Work?

Understanding hearing loss is easier when you understand how the ears work to allow you to hear.

Three parts of the ear work together to help us hear. 

  1. Outer Ear. The outer ear includes the pinna (the outside of the ear; the visible part you can see) and the ear canal. 
  2. Middle Ear. The middle ear contains the eardrum and the three small bones of the ear, the malleus, incus, and stapes.
  3. Inner Ear. The inner ear comprises the cochlea, the auditory nerve, the vestibule, and the semicircular canals. 

Sound waves pass into the outer ear and vibrate against the eardrum.

The eardrum amplifies the vibrations onto the bones of the middle ear. These bones vibrate the fluid inside the cochlea, stimulating the hair cells inside of it. 

The tiny hairs change the sound waves into electrical signals carried to the brain by the auditory nerve. The brain then interprets the electrical signals as sound. 

Damage to any of these structures may result in unilateral or bilateral hearing loss.

What Is Bilateral Hearing Loss?

Bilateral hearing loss is hearing loss that affects both of the ears. Hearing impairment can happen in just one ear (unilateral), usually due to an accident, infection, or congenital disability.

However, hearing loss that happens in both ears is bilateral. 

What Are the Symptoms of Bilateral Hearing Loss?

Generally, you’ll know you are experiencing hearing dysfunction when you begin to notice you don’t hear as well as you used to. Hearing loss may also have symptoms like:

  • Tinnitus, ringing or buzzing in the ears, which may be constant or happen from time to time.
  • A feeling of pressure or fullness in the ear, or feeling like there is something lodged inside the ear.
  • Inability to hear certain sounds, especially high-frequency sounds.

You may notice these symptoms immediately after exposure to a very loud sound, or over time, as part of progressive hearing loss.

How Is Bilateral Hearing Loss Diagnosed?

Your healthcare provider or audiologist will need to diagnose your level of hearing loss through a test called an audiogram.

An audiogram shows your degree of hearing loss by determining which frequencies you can and cannot hear. 

This test is minimally invasive and usually involves wearing a headset and responding when you hear a sound in one or both ears. 

What Are the Types of Bilateral Hearing Loss?

There are several different types of bilateral hearing loss. Treatment for any hearing loss is determined by the severity and the type of hearing loss you have experienced.

Conductive Hearing Loss

Hearing loss caused by middle and outer ear problems is called conductive hearing loss.

Profound hearing loss, a type of severe hearing loss that makes it impossible to hear someone shouting in the same room you are in, is a type of conductive hearing loss, although it can also come from sensorineural hearing loss. 


Conductive hearing loss is often genetic, including malformations with the structures of the outer and middle ears.

In addition, fluid build-up in the middle ear from colds or allergies may cause temporary or permanent conductive hearing loss. 

Ear infections, benign tumors, and a buildup of earwax are also causes of conductive hearing loss. 


Healthcare providers may prescribe antibiotics and other medications for colds and infections to help clear the infection and restore hearing.

If a buildup of earwax is the issue, a simple cleaning or earwax removal procedure may fix the problem. 

For genetic malformations, surgical intervention may be an option, as well as hearing devices like bone-conduction hearing aids, cochlear implants, and standard hearing aids.

Bilateral Sensorineural Hearing Loss

Sensorineural hearing loss is caused by inner ear problems, including the cochlea, auditory nerve, vestibule, and semicircular canals.

Damage here can affect how the brain interprets sound, preventing electrical signals from reaching the brain via the auditory nerve. 


Many of the causes of sensorineural hearing loss are the same as conductive hearing loss, including certain illnesses like meningitis, heredity, genetics, or tumors.

Other causes of sensorineural hearing loss include age-related hearing loss (also known as presbycusis), loud sounds, accidents (like head trauma), otolaryngology surgery (surgery of the head or neck that could damage cranial and auditory nerves), and diseases like Ménière’s disease.

In addition, some types of medication may cause temporary hearing loss.


Providers often prescribe corticosteroids to treat hearing loss from infection or autoimmune disease.

These can help reduce swelling in the hair cells. Surgical repair of inner ear structures may be an option in some cases, as well as hearing aids and cochlear implants. 

Mixed Hearing Loss

Mixed hearing loss occurs when a combination of hearing loss affects the structures of the outer ear, middle ear, and inner ear. 


The causes of mixed hearing loss can include any combination of the above causes of conductive and sensorineural hearing loss. 


Audiologists generally recommend treating the conductive hearing loss first.

This can make a person a better candidate for a hearing aid, cochlear implants, or surgical intervention. 

How Can I Maintain My Hearing Health?

Prevention is the best medicine. You can protect your normal hearing by making smart choices about the type of noise exposure and noisy environments you experience.

In general, loud noises above 70 decibels are considered hazardous to your hearing. 

Wearing protective hearing devices to help protect your hearing when you’re around loud noise is also important to prevent noise induced hearing loss.

Wear hearing protection (like earplugs or noise-canceling headphones) when you experience:

  • Loud music
  • Power tools
  • Lawn equipment like lawnmowers or leaf blowers
  • Loud vehicles, motorcycles, or off-road vehicles
  • Work environments that are noisy or loud

Protecting your hearing is also important because the tiny hair cells in the ear do not regenerate.

This means that when they become damaged or destroyed, a portion of your hearing is also permanently lost. 

For more information about hearing loss and hearing-related issues, check out the USA Rx blog, where you’ll find links to numerous health and wellness topics. 

In the meantime, take action to protect your hearing, and get assistance with any bilateral hearing loss you may have experienced. 

Using a hearing aid or other hearing device can dramatically improve your quality of life and make it easier for you to communicate with those around you. 

References, Studies and Sources:

Types, Causes and Treatments of Hearing Loss – the Basics|Hearing 

Bone Conduction Hearing Aids | Duke Health 

Sensorineural Hearing Loss|American Speech Language Hearing 

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