Hearing loss can vary greatly in degree and impact, from mild difficulty understanding speech in noise to a complete inability to hear sound. Among the more serious categories are severe and profound hearing loss — two conditions that significantly affect communication and quality of life. While they may sound similar, there are important differences in how they are defined, experienced, and managed.
This article explains the difference between profound and severe hearing loss, their causes, symptoms, and treatment options.
Contents
Understanding Hearing Loss Levels
Hearing loss is measured in decibels hearing level (dB HL), which indicates how loud a sound must be before it can be detected. The higher the number, the greater the hearing loss.
| Degree of Hearing Loss | Hearing Level (dB HL) | Description |
|---|---|---|
| Normal hearing | 0–25 dB | Can hear soft sounds clearly |
| Mild hearing loss | 26–40 dB | Trouble hearing faint speech or whispers |
| Moderate hearing loss | 41–55 dB | Difficulty understanding normal conversation |
| Moderately severe hearing loss | 56–70 dB | Only loud speech is heard |
| Severe hearing loss | 71–90 dB | Only very loud sounds are heard; conversation is unclear |
| Profound hearing loss | 91 dB or more | May only perceive vibrations or very loud noises |
What Is Severe Hearing Loss?
Severe hearing loss means a person struggles to hear most everyday sounds, even with amplification. Speech may be audible but not clear enough for full understanding.
Key characteristics:
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Hearing threshold between 71–90 dB HL
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May hear loud sounds such as shouting or traffic noise
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Ordinary speech becomes very difficult to understand
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Hearing aids can provide partial benefit
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Background noise severely affects communication
Example: A person with severe hearing loss may not hear someone speaking normally but could detect loud clapping or a car horn.
What Is Profound Hearing Loss?
Profound hearing loss is the most advanced degree of hearing impairment. Individuals with this condition hear very few sounds — and even those may be perceived as vibrations rather than clear tones.
Key characteristics:
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Hearing threshold of 91 dB HL or greater
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Speech cannot be understood without visual cues or sign language
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Hearing aids usually offer minimal benefit
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Cochlear implants or other assistive devices may be required for communication
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Early onset profound loss can severely affect speech and language development in children
Example: A person with profound hearing loss may only sense the vibration of a drum or a passing truck, but not the sound itself.
Main Differences Between Severe and Profound Hearing Loss
| Aspect | Severe Hearing Loss | Profound Hearing Loss |
|---|---|---|
| Hearing threshold | 71–90 dB HL | 91 dB HL and above |
| Speech understanding | Can hear loud speech but clarity is poor | Cannot understand speech even when loud |
| Perception of sound | Loud sounds are audible | Only very loud sounds or vibrations are felt |
| Benefit from hearing aids | May provide useful amplification | Limited or no benefit |
| Common treatment | High-power digital hearing aids | Cochlear implants or specialized assistive devices |
| Communication methods | Speech with amplification | Sign language, lip reading, or implants |
Causes of Severe and Profound Hearing Loss
Both types can result from similar causes, but profound loss usually indicates more extensive inner ear or nerve damage.
Common causes include:
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Genetic factors (hereditary deafness)
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Long-term exposure to loud noise
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Aging (presbycusis)
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Infections such as meningitis or measles
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Ototoxic medications (certain antibiotics, chemotherapy drugs)
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Head injury or trauma
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Inner ear malformations present from birth
Diagnosis
Diagnosis involves a thorough audiological evaluation, including:
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Pure Tone Audiometry (PTA): Measures the softest sounds you can hear at various pitches.
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Speech Audiometry: Assesses understanding of spoken words.
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Tympanometry: Checks middle ear function.
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Otoacoustic Emission (OAE) or BERA testing: Especially useful for infants and non-verbal patients.
These tests help determine the exact degree and type of hearing loss, guiding treatment options.
Treatment Options
For Severe Hearing Loss:
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High-power digital hearing aids with advanced noise reduction.
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Assistive listening devices (FM systems, Bluetooth streamers).
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Speech therapy and auditory training for better speech understanding.
For Profound Hearing Loss:
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Cochlear implants, which directly stimulate the auditory nerve.
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Bone-anchored hearing systems (BAHA) in some cases.
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Sign language or lip reading training.
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Auditory-verbal therapy for children after implantation.
Living with Severe or Profound Hearing Loss
Modern technology and early intervention can dramatically improve communication and quality of life. Many people with profound hearing loss successfully use cochlear implants, while those with severe hearing loss benefit greatly from digital hearing aids and professional rehabilitation.
Family support, counseling, and consistent follow-up with an audiologist are essential for the best outcomes.
Conclusion
The main difference between severe and profound hearing loss lies in how much sound a person can perceive and how effective hearing aids are.
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Severe hearing loss allows some sound recognition with amplification.
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Profound hearing loss means little to no sound perception, often requiring cochlear implants.
Early diagnosis and treatment can make a world of difference — especially for children and working adults.
If you or a loved one experience significant hearing difficulties, visit a qualified audiologist or ENT specialist for a detailed evaluation and personalized hearing solution.