Discover what conductive hearing loss is, its causes, and effective treatment options. Learn everything about “What Is Conductive Hearing Loss?” on our blog!
What is conductive hearing loss?
Conductive hearing loss happens when sound can not fully get to the inner ear. This can be because there are problems in the outer ear, the tympanic membrane, or the middle ear structures. This type of hearing loss is a main type that people have. It is the most common cause of muffled or soft hearing, especially in young children. Many cases of conductive hearing can get better with medical help, surgical procedures, or using devices to help you hear. Conductive hearing loss is not like sensorineural hearing loss. Sensorineural hearing loss starts when there is damage in the inner ear or the parts that send sound to the brain.
What causes conductive hearing loss?
Conductive hearing loss is a type of hearing loss. It happens when something blocks, damages, or does not work right in the external auditory canal or in the middle ear. Sometimes, eustachian tube dysfunction or acute otitis media can be the cause of this. A fluid build-up in the ear drum or problems with the middle ear bones can also cause conductive hearing loss.
There are 7 common causes of conductive hearing loss. The most common causes of conductive hearing loss stop sound from moving into the cochlea as it should. These causes stop sound from passing through the external auditory canal and the middle ear the right way.
| Cause | Example Conditions |
|---|---|
| Impacted earwax | Excess cerumen blocking sound waves |
| Foreign objects in the ear | Beads, toys, or cotton swab tips |
| Otitis externa | Swimmer’s ear causing canal inflammation |
| Tympanic membrane perforation | Hole or rupture due to trauma or infection |
| Otitis media | Fluid buildup from middle ear infections |
| Dislocation or erosion of bones of the middle ear | Dislocation or erosion of bones of the middle ear |
| Otosclerosis | Abnormal bone growth fixing the stapes |
Blockages in the middle ear, like wax or something else, can keep sound from reaching the eardrum. Sometimes fluid builds up in this area because of ear infections. Other problems, like otosclerosis or when the small bones in the ear are not joined right, can also stop sound from getting through the ear how it should.
How is conductive hearing loss different from other types?
Conductive hearing loss happens when sound does not move through the external or middle ear as it should. This type of hearing loss is hard for people because the parts that carry sound to the inner ear do not work the right way.
Sensorineural hearing loss is a different type of hearing loss. It is not the same as conductive hearing. In this type, the cochlea or the hearing nerve (also called the auditory nerve) has the problem. People can have a tough time hearing even when sound goes into the ear.
| Feature | Conductive Hearing Loss | Sensorineural Hearing Loss |
|---|---|---|
| Affected Area | External/middle ear | Inner ear (cochlea) or auditory nerve |
| Perception | Sounds seem muffled or quiet | Difficulty distinguishing speech or high pitches |
| Causes | Blockages, fluid, injury | Noise exposure, aging, nerve damage |
| Treatment | Often treatable or reversible | Usually permanent; managed with hearing aids |
| Rinne Test Result | Bone > Air conduction | Air > Bone (but both reduced) |
| Weber Test Result | Louder in affected ear | Louder in unaffected ear |
In mixed hearing loss, a person has both conductive and sensorineural hearing loss at the same time. Because of this, the treatment can be more involved. It may take extra steps to help someone with mixed hearing loss.
What are the symptoms of conductive hearing loss?
The 5 major symptoms of conductive hearing loss include:
- Trouble hearing soft sounds, which may feel like voices or noises are too quiet.
- A sense that your ears feel full or like there is pressure inside them.
- Hearing your own voice louder than others around you.
- A muffled or blocked feeling when you listen, as if something is in your ear.
- Ears that feel painful or uncomfortable at times.
These are common symptoms of conductive hearing loss. If you notice these in yourself or someone you know, it may be the right time to get help from a doctor. Conductive hearing problems can come from many things, but the right treatment can often make it better.
- Muffled or soft sounds — This is something that happens most with low sounds.
- Ear discomfort or fullness — This can often come from having fluid inside or an infection. It can also make it hard to hear and lead to difficulty hearing.
- Ear discomfort or fullness — This is usually because of fluid in the ear or an infection.
- Discharge from the ear — This can be a sign that there is an infection or maybe an injury.
- Sudden hearing changes — This can happen if water gets in the ear or if there has been an injury.
Children may have delayed speech, not do well in school, or get ear infections a lot. These signs mean you should take them to see a doctor right away.
How do doctors diagnose conductive hearing loss?
Conductive hearing loss is found with physical exams and hearing tests. Doctors use these steps to find out where the problem is in the path of hearing. This helps the doctor learn more about conductive hearing and what causes the hearing loss.
1. Physical examination and patient history
- Otoscopy lets you see if there is something blocking the ear, an infection, or a hole in the tympanic membrane.
- A look at the patient history can show if there have been problems such as repeated otitis media, an injury, or a defect someone has had from birth.
- People often feel symptoms like ear pain, dizziness, and otorrhea (which means ear discharge).
2. Audiometric testing and tuning fork exams
| Test Type | Purpose |
|---|---|
| Pure Tone Audiometry | Measures air and bone conduction to identify an air-bone gap |
| Tympanometry | Evaluates eardrum mobility and middle ear pressure |
| Rinne Test | Compares air vs. bone conduction in each ear |
| Example: In conductive loss, bone conduction is louder than air conduction (Rinne negative), and sound localizes to the affected ear (Weber test) which is part of tuning fork tests. | Lateralizes sound to affected or unaffected ear for type differentiation |
In a conductive loss, bone conduction is louder than air conduction. This is known as a Rinne negative test. When you do the Weber test, the sound will be heard more on the affected ear.
Can conductive hearing loss be cured?
Yes, conductive hearing loss can often get better if doctors find the main problem and treat it the right way. Sometimes, you can use assistive listening devices as part of your plan to fix conductive hearing loss. In the table below, there are 6 common causes of conductive hearing loss. Each cause of conductive hearing loss has different treatment options. If you get an early diagnosis, you have a better chance to get all your hearing back.
| Cause | Treatment Options |
|---|---|
| Impacted earwax | Manual removal or cerumenolytic drops |
| Otitis externa | Topical antibiotics and anti-inflammatories |
| Otitis media | Oral antibiotics or myringotomy for drainage |
| Tympanic membrane perforation | Tympanoplasty (eardrum repair) |
| Ossicular problems | Ossiculoplasty or stapedectomy |
| Otosclerosis | Surgery or hearing aids if surgery is not suitable |
Is conductive hearing loss permanent?
No, conductive hearing loss is usually not there for all time. Most often, this type of hearing loss is not for good and can get better when the main cause is looked at and treated. For example, if conductive hearing loss is because of earwax, fluid in the ear, or ear infections, fixing these problems often helps the hearing get better. But sometimes, conductive hearing loss can still be for life. This can happen if you get hurt, or there is harm to the eardrum or small bones in the ear. Some problems like ongoing ear infections, injuries, or a health issue called bad otosclerosis can make this type of hearing loss stay.
Temporary causes:
- Impacted wax
- Acute infections
- Foreign objects
Permanent causes:
- Chronic ossicular erosion can take place as time goes by and may make hearing worse for people.
- Unrepaired tympanic membrane rupture means the eardrum did not get better and is still damaged.
- Advanced otosclerosis is a problem that gets worse with time and can change how the ear works.
Getting checked and treated on time can make a big difference. It can stop lasting problems. People may also hear better, even when there is background noise.
Who is at risk for conductive hearing loss?
People of all ages can get this. But, some groups feel it the most:
| Population | Common Risk Factors |
|---|---|
| Children | Frequent middle ear infections, small ear canals |
| Swimmers | Otitis externa due to water exposure |
| Elderly | Ossicular degeneration or otosclerosis |
| Earbud users | Impacted wax or accidental trauma from cotton swabs |
Hearing loss in kids can slow development. This is why it is good to have early screening. It helps make sure that language and thinking skills grow the way they should.
How can conductive hearing loss be prevented?
5 ways to reduce the risk of conductive hearing loss:
- Keep your ears clean. Gently clean the outer ear. Do not put anything, like cotton swabs, inside the ear canal. This can push wax deeper or hurt your ear.
- Protect your ears from water. After you swim or bathe, dry your ears well. If you swim a lot, use earplugs. This can help stop water from staying in the ear and keep you safe from ear infections.
- Treat ear infections early. If you feel pain, see swelling, or notice liquid coming out of your ear, go to a doctor right away. A fast visit to a doctor can keep the problem from getting worse and may stop conductive hearing loss.
- Avoid loud noises and injuries. A strong hit to the head or ear can damage your ear and lead to conductive hearing loss. Wear gear to protect yourself when you play sports or are around loud noise.
- Watch for changes in your hearing. If you have trouble hearing or feel pressure in your ears, get your ears checked. A doctor can help find the cause and work to fix it before it leads to a bigger hearing loss.
Doing these easy things may help you keep your ears healthy. This can lower the chance of getting conductive hearing loss.
- Do not put objects in the ear canal. This includes cotton swabs. You can hurt the ear if you do this.
- Get treatment for ear infections quickly. This helps stop fluid from building up. It can also help stop other problems before they start.
- Dry your ears after swimming. This will help lower the chance of getting otitis externa.
- Use ear protection when the air pressure changes, like if you go flying or diving.
- Book regular hearing checkups. Make sure to do this if children often get ear infections or always have problems with their ears.
Preventive care is very important. It helps you keep your hearing good for a long time. It can also make it less likely that you will need a big or hard treatment later.
