Mixed hearing loss has elements of both conductive hearing loss and sensorineural hearing loss. This means there is damage to both the outer and inner ear. The outer ear cannot conduct sound properly to the inner ear, and the inner ear can’t process the sound to be sent to the brain. The sensorineural component (inner ear) is usually permanent, but the conductive hearing loss (outer ear) may not be. Many people with mixed hearing loss experience sounds as very soft in volume and difficult to understand.