3 Types of Ear Infections That Can Affect Your Hearing

How to recognize the symptoms, what causes them and when you need to see a doctor

Frank Lin, M.D., and Nicholas Reed, Au.D.,

Updated August 15, 2025

AARP

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En español

Published October 17, 2022

/ Updated August 15, 2025

man holding his hand over his ear looking like he is in pain

IAN HOOTON/SPL/Getty Images

Key takeaways:

External ear infections can be caused when moisture is trapped in your ear canal.
Trapped fluid also causes most middle ear infections.
Inner ear infections are rare and are thought to be caused by viruses in the ear.
All three types of ear infections can cause different kinds of hearing loss.

Adapted from AARP’s Hearing Loss for Dummies, by Frank Lin, M.D., and Nicholas Reed, Au.D.

At some point in your life, you’ve probably had an ear infection. But did you know that ear infections can temporarily — or permanently— affect your hearing?

What causes ear infections?

Ear infections can actually involve any of the three parts of your ear — external, middle and inner.

Infections of the external or middle ear generally just lead to a temporary conductive hearing loss until the infection resolves, whereas infections of the inner ear often lead to a permanent sensorineural hearing loss. (See box on types of hearing loss.)

Types of ear infections

1. External ear infections

Authors Frank Lin, M.D., and Nicholas Reed, Au.D. lay out the steps to you need to know to maintain better hearing health, how to manage can damage your hearing, such as impacted earwax, ear infections and tinnitus.

AARP

An external ear infection is when the skin of the ear canal becomes infected. This can be triggered by too much moisture in the ear canal (often known as swimmer’s ear), which makes it easier for bacteria to grow. Another common cause is when someone sticks their finger or a cotton swab in the ear and inadvertently traumatizes the skin, leading to an infection. External ear infections often cause pain, swelling and drainage from the ear, and may occasionally be accompanied by a temporary decrease in hearing related to swelling or infected material in the ear canal that prevents sound from getting to the eardrum. Once this infection resolves, the transient hearing loss resolves as well.

If you think you have an external ear infection, contact your primary care physician or an ENT (ear, nose and throat doctor), because you may need the ear cleaned and antibiotic ear drops or pills.

2. Middle ear infections

Middle ear infections generally occur when fluid accumulates in the middle ear space and gets infected, leading to a temporary conductive hearing loss. To understand how this happens, let’s take a look at the role of the mysterious Eustachian tube.

This is a fancy term for a narrow tube that connects the middle ear space to the very back of the nose. This tube is critically important, because it’s the structure that allows air to move back and forth between the middle ear and the outside environment.

The air in the middle ear space is constantly getting absorbed by the lining of the middle ear, which is similar to the lining of the lungs. The cells of this lining are designed to absorb air. The Eustachian tube, therefore, allows “new” air to get in from the outside to replenish the air in the middle ear as it is gradually absorbed over the course of the day.

Imagine what would happen if the Eustachian tube weren’t open and air couldn’t get to the ear to replenish the air that’s getting absorbed. In this case, the middle ear space would rapidly become a vacuum (in other words, there wouldn’t be enough air pressure) because the air would be absorbed by the lining of the middle ear.

As you may have heard, “Nature abhors a vacuum,” and it’s true here as well. With a vacuum in the middle ear, the middle ear space gets filled with fluid that’s sucked out of the cells lining the middle ear. It sounds a bit crazy, but it’s true.

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Fluid collecting in the middle ear can lead to a sense of pressure and fullness in the ear as well as a temporary hearing loss, as sounds can’t be transmitted effectively to the inner ear through the fluid.

If the fluid gets infected, you’ll also notice lots of pain, which may be accompanied by a fever. If you think you have a middle ear infection, you’ll definitely want to see your primary care physician or an ENT, because you may need oral antibiotics to treat the ear infection.

Middle ear infections can most often be triggered by a cold or nasal allergies. In these cases, the lining of the nose and the back of the throat can get swollen and inflamed, which blocks the opening around the Eustachian tube, preventing air from getting back and forth.

The good news is that the hearing loss caused by a middle ear infection is only temporary until the infection resolves and the fluid in the middle ear drains out through the Eustachian tube.

diagram of an ear with labels for the outer ear, middle ear and inner ear

Ear Diagram

iStock / Getty Images Plus

3. Inner ear infections

Unlike external and middle ear infections, which are relatively common and have symptoms that resolve after being treated, inner ear infections are relatively rare and far more dangerous to your hearing. The inner ear is generally resistant to ear infections, since it’s hard for bacteria and viruses to get into and infect the fluid of the inner ear. Unfortunately, while it’s rare, scientists estimate that about 1 in 10,000 to 50,000 people a year get inner ear infections.

In these cases, doctors think that most commonly some type of virus manages to get into the inner ear and damage the inner ear, leading to a sudden loss of hearing. Not surprisingly, it’s called a sudden sensorineural hearing loss. SSNHL is an urgent medical condition. The earlier it’s diagnosed and treated (ideally within three to five days), the better the chance of some recovery of hearing.

The key thing to note about an SSNHL is that the hearing loss comes on suddenly — over a period of minutes — and often completely out of the blue in just one ear. In contrast, hearing loss from an external or middle ear infection is not nearly so sudden or severe, is often accompanied by other symptoms and may affect both ears. If you experience a sudden change in hearing, see an ENT doctor right away.

Types of Hearing Loss

Sensorineural hearing loss is the most common type of hearing loss, caused by cellular damage in the inner ear. It can be treated with communication strategies, hearing aids or cochlear implants, but it’s not reversible by any pharmacologic or surgical intervention at this time.
Conductive hearing loss is when sound cannot get to the inner ear to be encoded and sent to the brain. Examples of conductive hearing loss include external and middle ear infections, impacted earwax, fluid in the ears, or a growth in the middle ear space — anything that blocks sound from getting to the inner ear. An ENT can correct many conductive losses.
Mixed hearing loss is when an individual has both sensorineural and conductive hearing loss. For example, a person may have a mild sensorineural hearing loss but then gets a cold that causes the middle ear space to fill with fluid, which prevents sound from getting to the inner ear.

Types of Hearing Loss

Sensorineural hearing loss is the most common type of hearing loss, caused by cellular damage in the inner ear. It can be treated with communication strategies, hearing aids or cochlear implants, but it’s not reversible by any pharmacologic or surgical intervention at this time.
Conductive hearing loss is when sound cannot get to the inner ear to be encoded and sent to the brain. Examples of conductive hearing loss include external and middle ear infections, impacted earwax, fluid in the ears, or a growth in the middle ear space — anything that blocks sound from getting to the inner ear. An ENT can correct many conductive losses.
Mixed hearing loss is when an individual has both sensorineural and conductive hearing loss. For example, a person may have a mild sensorineural hearing loss but then gets a cold that causes the middle ear space to fill with fluid, which prevents sound from getting to the inner ear.