Mixed hearing loss is a combination of conductive and sensorineural hearing loss. Conductive hearing loss occurs when sound transmission is impaired through the outer or middle ear, while sensorineural hearing loss results from dysfunction in the inner ear or auditory nerve. Mixed hearing loss can be caused by ear infections, childhood illnesses, head trauma, family history, or complications during pregnancy. People with mixed hearing loss may have difficulty hearing clearly or fully, frequently ask for repetition, tire easily from straining to hear, and avoid social situations. While conductive hearing loss may sometimes be medically treated, sensorineural hearing loss is usually permanent. Hearing aids can help with mixed hearing loss if no active ear infection is present.