Category: Hearing Loss

Conductive Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment

TL: DR; This blog is written for adults, parents, caregivers, and families who are noticing muffled hearing, ear blockage, ear pain, repeated ear infections, or hearing difficulty in children or older adults. Conductive hearing loss occurs when sound cannot pass properly through the outer or middle ear to reach the inner ear, often due to a physical or mechanical issue. Common causes include earwax blockage, middle ear infections, glue ear in children, perforated eardrum, otosclerosis, Eustachian tube dysfunction, foreign objects, or structural ear problems. Key symptoms include muffled hearing, reduced sound clarity, ear fullness or pressure, mild pain, ear discharge, tinnitus, increased TV or phone volume, and delayed speech or inattentiveness in children. Conductive hearing loss is often treatable with the right diagnosis and may be managed through earwax removal, infection treatment, medications, surgery, hearing aids, bone-anchored hearing aids, home visits, online consultations, and aftercare support. When sound is blocked, hearing is muffled, the ear hurts, there are frequent ear infections or difficulty hearing clearly after a cold, it can feel worrying. These symptoms often occur when sound is not conducted normally through the outer and/or middle ear. This is referred to as conductive hearing loss. It indicates that something might be wrong with the portion of the ear that conducts sound to the inside, including the ear canal, eardrum, or middle ear. May occur from earwax, fluid, infection, eardrum issues, or other middle ear problems. The good news is that once the cause of conductive hearing loss is properly diagnosed, it can be treated or improved. This is why it is important not to ignore the symptoms or assume the hearing loss is permanent, but to undergo a proper hearing assessment. Our audiologists evaluate hearing issues in children, adults, and seniors at Resonnocare. This guide can help you understand the following: What is conductive hearing loss? Some common causes of conductive hearing loss. What signs to look for. How is conductive hearing loss diagnosed? What treatment options are available? What Is Conductive Hearing Loss? Conductive hearing loss occurs when sound does not pass through the outer ear or middle ear. Although sound can reach the inner ear, it may be weak, blocked, or unclear. To gain a better understanding, it is useful to know how hearing works normally. Sound first passes through the external (outside) ear and down the ear canal. It is then transmitted to the drum and then passes through three small bones within the middle ear. The vibrations then pass into the inner ear, where they are converted into a signal the brain can interpret. In conductive hearing loss, the issue typically occurs before sound reaches the inner ear. This is why people often feel that their hearing is blocked, muffled, or even diminished, rather than a total loss of hearing. Conductive hearing loss is not the same as sensorineural hearing loss, which is typically associated with the inner ear or the hearing nerve. It also differs from mixed hearing loss, in which both the external ear (conductive) and the inner ear (sensorineural) are involved. An appropriate hearing test can indicate the nature of the hearing loss and the potential cause. This is crucial as the next step in the care pathway will depend on the site of the hearing problem. What Does Conductive Hearing Loss Look Like on an Audiogram? A typical conductive hearing-loss pattern may show poorer air-conduction hearing thresholds while bone-conduction thresholds remain better. The difference between these two measurements is commonly described as an air–bone gap. In simple terms, the pattern suggests that the inner ear can respond to sound better than sound can travel through the outer or middle ear. However, an audiogram pattern by itself does not identify the exact cause of the blockage or mechanical problem. The audiologist may consider: Air-conduction thresholds Bone-conduction thresholds Whether an air–bone gap is present Whether one or both ears are affected The degree and shape of hearing loss Tympanometry findings Ear examination findings The patient’s symptoms and medical history For example, earwax, middle-ear fluid, an eardrum problem, and an ossicular problem can all produce conductive hearing loss but may require very different treatment. What Causes Conductive Hearing Loss? There are several common causes, and treatment depends on identifying the correct one. There are simple and reversible causes. Others need medical or surgical treatment. In clinical practice, one of the most common causes is earwax blockage. Wax builds up and hardens in the ear canal, blocking sound from reaching the eardrum. It can occur in anyone at any age. Middle ear infection (otitis media) is very common in children. Fluid or pus accumulates behind the eardrum, reducing its ability to vibrate freely. A chronic form of the condition known as glue ear, in which thick, sticky fluid builds up in the middle ear without infection, is a common cause of conductive hearing loss in school-age children. Depending on the size and location of the perforation, a perforated eardrum can also drastically affect hearing, which may result from infection, trauma, or sudden changes in pressure. Otosclerosis is a disorder that affects the middle ear, in which abnormal bone growth causes one of the three ossicles (usually the stapes) to become stuck and to move incorrectly. It causes progressive conductive hearing loss and is more common in young and middle-aged adults. Foreign objects in the ear canal, abnormal growths such as cholesteatoma, and congenital structural abnormalities can also cause similar symptoms. In certain patients, Eustachian tube dysfunction may make it difficult for the middle ear to maintain normal pressure, leading to a feeling of fullness or muffled hearing. What Are the Symptoms of Conductive Hearing Loss? Conductive hearing loss can make sounds seem as though you are hearing through a filter or with your fingers in your ears. Sounds quieter, less distinct, or muffled. You might find yourself having to turn up the volume on your television, phone, or computer, hearing only half of what people are saying, or not hearing well in noisy places.