An audiogram demonstrates air conduction thresholds averaging 60 dB HL and bone conduction thresholds averaging 30 dB HL. How should this impairment be categorized?

• A. Sensorineural hearing loss
• B. Retrocochlear hearing loss only
• C. Mixed hearing loss
• D. Pure conductive hearing loss

Answer: (C)

Think in terms of what the air and bone conduction results say about the two hearing pathways. Bone conduction at 30 dB HL indicates a sensorineural component (inner ear or nerve is not normal). Air conduction at 60 dB HL is worse by 30 dB, creating an air–bone gap, which signals a conductive component (outer or middle ear issue) alongside the sensorineural loss. A purely conductive loss would have a normal bone threshold with a depressed air threshold, and a purely sensorineural loss would show elevated air and bone thresholds with little or no gap. Because both pathways are elevated and there’s a clear air–bone gap, this pattern fits mixed hearing loss.