When a person has conductive hearing loss, sound cannot pass through the outer and middle ear to reach the inner ear. This can be due to a blockage or damage.

The ear comprises three parts — the outer, middle, and inner ear. People with conductive hearing loss to hear soft sounds, while louder sounds may be muffled.

Doctors are often able to treat conductive hearing loss with medication and surgery.

This article discusses the symptoms, causes, diagnosis, and treatment of conductive hearing loss. It also answers some common questions about the condition.

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People with conductive hearing loss often have difficulty hearing soft or low volume sounds. Some individuals may find they need to turn up the volume of speakers, phones, and televisions to much louder volumes than before. This may be an indication of conductive hearing loss.

Other symptoms of conductive hearing loss may include:

Conductive hearing loss occurs when sound cannot reach the inner ear due to damage or a blockage. These can occur due to:

An ear, nose, and throat (ENT) doctor may diagnose conductive hearing loss. They will typically begin by asking the person about their medical history and symptoms before performing a physical examination.

A doctor may perform several tests to make a diagnosis.

Pure tone audiometry

This hearing test involves a doctor using an audiometer to generate tones. The tones vary in volume, which the doctor measures in decibels, and pitch, which they measure in Hertz.

During the test, the person may be in a sound booth and will wear headphones and a bone conductor. This device causes gentle vibrations that travel to the inner ear.

The healthcare professional will play a sound, and the person will signal when they hear it by pressing a button or raising a hand. The test can help determine their hearing threshold, which indicates the softest sound they can hear.

Tympanometry

In this test, a doctor uses air pressure to test vibrations between the eardrum and middle ear. They insert a small earphone-shaped probe into the ear and push air through it from an attached device.

How the eardrum moves in response to the air can help the doctor determine whether there is a buildup of wax in the ear, fluid in the middle ear, or a hole in the eardrum.

Acoustic reflex measures

In this test, a doctor will play a sound through a probe in a person’s ear and measure the tightening of a small muscle in the middle ear. This muscle reacts to loud noises, and the tightening is an acoustic reflex. The doctor will monitor how loud a sound needs to be before a person experiences the acoustic reflex.

Static acoustic impedance

This test can help a doctor measure how much air is in the ear canal, which shows if there is a hole in the eardrum or if there is fluid behind the eardrum.

Imaging tests

Tests that allow the doctor to see the structure of the ear, such as CT scans or MRI scans, can show areas that are damaged or blocked.

Treating conductive hearing loss depends on the cause of the hearing loss.

Extraction

This treatment involves a healthcare professional removing a foreign object from the ear or using a suction tool to clear wax and debris from the ear.

Monitoring

In the case of otitis media with effusion, which means there is a buildup of fluid in the ear, but no signs of infection or eardrum perforation, a person may not require treatment.

Otitis media with effusion usually resolves itself, although a person can consult a doctor every 3 months to monitor the condition and make sure it has cleared up.

Perforations in the eardrum also typically heal without intervention, but a person may speak with a doctor after 6–8 weeks to assess the condition.

Medication

In cases of ear infection, a doctor may prescribe antibiotics. However, people with ear infections often recover without medication.

Surgery

Types of surgery include:

  • Myringoplasty: If a hole in the eardrum does not heal, a surgeon can close it during surgery.
  • Myringotomy: A surgeon makes a small incision in the eardrum to relieve pressure and drain fluid.
  • Mastoidectomy: If a person has cholesteatoma — an atypical growth of skin that can develop in the middle ear — a surgeon may remove diseased cells from air-filled spaces near the inner ear.
  • Stapedectomy: In this surgery, surgeons replace a small bone in the ear with an artificial device.

Devices

If there is no way for doctors to treat conductive hearing loss, a person may improve their hearing by using hearing aids. Types of hearing aids include:

  • air conduction hearing aids
  • bone conduction hearing aids
  • bone anchored hearing aids

Below are some of the most common questions and answers about conductive hearing loss.

Is conductive hearing loss serious?

The seriousness of conductive hearing loss depends on the cause of the condition and its severity. In some cases, a person may require surgery as they risk the hearing loss becoming permanent. In other cases, it may resolve following treatment. It could also get better on its own.

Can earwax cause conductive hearing loss?

Yes, a buildup of earwax can result in conductive hearing loss. A doctor can safely remove earwax from the ear with a suction tool. However, people should not attempt to clean their inner ears with cotton swabs or any small implements, as this can damage the ear and worsen the problem.

Who does conductive hearing loss affect?

Conductive hearing loss can affect anyone but is most common in children.

Conductive hearing loss occurs when sound cannot reach the inner ear. The severity, length, outlook, and treatment for conductive hearing loss are dependent on the cause of the condition.

Causes range from easily treatable situations, such as a buildup of earwax, to more serious causes, which may require surgery.

To diagnose conductive hearing loss, a doctor may perform tests that include audiometry, tympanometry, and acoustic reflex tests. Treatment depends on the cause of the condition and can range from monitoring the condition to surgery.

A person should speak with a doctor if they think they are experiencing conductive hearing loss.