What is conductive hearing loss?
Conductive hearing loss happens when there is a blockage of some kind in the outer or middle ear that prevents sound from properly passing through to the inner ear. You can experience it in one or both ears.
Symptoms of conductive hearing loss
In a similar way to if you were wearing ear plugs, or covering your ears, conductive hearing loss affects the way we perceive sound levels. So you might find it sounds like everything is muffled, or just quieter than normal.
Other symptoms of conductive hearing loss include:
- The loudness of the sound diminishes but not the clarity
- Trouble hearing conversations
- Difficulty perceiving quiet sounds
- Obvious differences in hearing in each ear
- A feeling of pressure or discomfort
- A difference in how your voice sounds to you
- You feel that your own voice sounds different
You’ll find that speech is clear and there’s no distortion, but it just needs to be louder for you to properly hear.
Flat hearing loss
Flat hearing loss is one type of conductive hearing loss where your test results will show a ‘flat loss’, which means that your hearing is affected at all frequencies.
The symptoms of flat hearing loss include:
- Not being able to hear low tones, often associated with tinnitus
- Your own voice sounding very loud
- Perforated eardrum — a tear or hole in the eardrum
- Ear malformation — Congenital abnormal development can lead to structural defects of the outer and middle ears that lead to conductive hearing loss in children
- Eustachian tube dysfunction — a condition that affects the tubes connecting the ear to the throat
- Abnormal growths — non-cancerous growths can sometimes develop in the ear canal, which makes it much narrower and more likely to cause obstructions. These are commonly present at birth or develop from repeated ear infections
- Otosclerosis — The hardening of the middle ear structure, or otosclerosis, affects about 1% of the population. Surgery can usually correct this condition; you can find more information on this further down the article.
Diagnosis for conductive hearing loss
Due to the variety of potential causes, conductive hearing loss might be diagnosed by either a GP or an audiologist.
They’ll ask you about your hearing loss and about any other symptoms you might have, as well as your history. They will also examine your ears and check for any signs of infection, damage or blockage in the ear using an instrument called an otoscope.
They might also choose to carry out an audiogram and tympanogram. An audiogram tests for hearing loss, whereas a tympanogram tests the pressure within the ear by measuring how mobile the eardrum is. If there is a change in the pressure, then it will affect how the sound is conducted through the ear.
In a similar way to diagnosing sensorineural hearing loss, some tests will be conducted using a tuning fork, known as the Weber and Rinne tests.
Treatment for conductive hearing loss
Most cases of conductive hearing loss are temporary and generally can be sorted out by treating the underlying condition. For example, removing the foreign body from the ear, taking antibiotics or medication for an ear infection, or clearing away impacted earwax may be all it takes to restore hearing — you can book an earwax removal appointment here.
In some cases, people may benefit from wearing hearing aids to amplify quiet sounds. There is also a surgical option for some people to treat their conductive hearing loss, for example if it is due to a growth in the ear canal.
If you’re prone to ear infections and they are a recurring issue, as often happens in children, your doctor may offer you a type of surgery where a small tube (known as a grommet or pressure equalisation tube) will be placed across the eardrum to help fluid drain from the middle ear to the eardrum and help prevent build-up.
- Le saux N, Robinson J.L., Management of acute otitis media in children six months of age and older, Paediatr Child Health, 2016;21(1):39-50.