Which type of hearing loss typically results in reflex absence at severe levels?

Sensorineural hearing loss is characterized by damage to the inner ear (cochlea) or the auditory nerve pathways to the brain, which can significantly impair the ability to process auditory information. At severe levels of sensorineural hearing loss, the auditory reflexes—specifically the acoustic reflex—often become absent. This absence occurs because the structures responsible for triggering this reflex, including the cochlea and the auditory pathways, are compromised.

In contrast, conductive hearing loss involves issues in the outer or middle ear that prevent sound from being conducted to the inner ear. While reflexes may be present, they can be reduced due to the inability to effectively transmit sound. Mixed hearing loss combines elements of both conductive and sensorineural types, which may complicate reflex responses but does not lead to a blanket absence at severe levels.

Functional hearing loss, on the other hand, is not due to anatomical or physiological dysfunction. Instead, it involves psychological factors and typically does not present with absent reflexes because the auditory structures are functioning normally. Therefore, the characteristic pattern of absent reflexes at severe levels is primarily associated with sensorineural hearing loss.