Conductive Hearing Loss: Types, Causes, and Treatments
Dr. Angel Rivera
Hearing loss affects millions of people worldwide, adults and children alike. But not all hearing loss is created (or caused) equally.
While it is true that most cases of hearing loss are simply a result of aging, that is not the only culprit.
Hearing loss can have many risk factors, ranging from heredity, trauma, environmental conditions, and more.
Here, we will seek to explore conductive hearing loss and examine some of its causes and the various available treatments.
What Is Hearing Loss?
According to data from the Hearing Loss Association of America, around 48 million people live with some degree of hearing loss in the United States.
But, these numbers only account for those diagnosed with hearing loss.
On average, people with hearing loss wait around seven years before seeking help.
This condition is also one of the most common conditions worldwide.
Hearing loss affects more than five percent of the world’s population — around 430 million people. These numbers may double by 2050.
Symptoms and Degrees of Hearing Loss
There are many symptoms of hearing loss and degrees of severity. Here are a few symptoms of hearing loss to look for:
- Conversations are difficult in noisy environments.
- Having to constantly turn up the volume on the TV or radio.
- Tinnitus (ringing in the ears).
- High-pitched voices are harder to discern.
- Difficulty discerning where sounds are originating.
Degrees of Hearing Loss
Hearing loss is actually measured in degrees or severity. It can range from mild to profound hearing loss.
These degrees of hearing loss are measured using decibels (dB).
A normal hearing has a decibel range from 0 to 20.
Mild to moderate hearing loss can climb up to 55 dB, while more severe forms of hearing loss are 90 dB and beyond. An audiologist determines these ranges.
What Are the Types of Hearing Loss?
Typically, hearing loss is in two categories: Sensorineural and conductive. Mixed hearing loss is considered a third category but is just a combination of the two.
Sensorineural Hearing Loss
Per the National Institute on Deafness and Other Communication Disorders, age remains one of the strongest predictors of hearing loss among adults aged 20 to 69.
Clinically, this is age-related hearing loss or presbycusis.
Age-related hearing loss falls under the category of sensorineural hearing loss.
This form of hearing loss is typically degenerative and occurs gradually over time as we age, though it can happen suddenly too — sudden sensorineural hearing loss (SSHL).
The inner ear includes the cochlea, interconnected semicircular canals, nerves, and important hair cells.
Components like the auditory nerve and hair cells can degenerate from age or be damaged through long-term exposure to loud noise. The result is hearing loss.
That is where amplification devices like hearing aids or cochlear implants can offer some help to restore some degree of hearing.
Conductive Hearing Loss
While most cases of hearing loss result from normal aging, conductive hearing loss can happen to anyone at any age.
Conductive hearing loss occurs when sounds cannot pass through the outer ear, the ear canal, and the middle ear.
The prevention of sound is often the result of some type of obstruction or even trauma.
While most cases of conductive hearing loss are temporary, permanent hearing loss is also possible.
Conductive hearing loss can be unilateral, occurring in only one ear, or bilateral, which occurs in both ears.
What Are Symptoms of Conductive Hearing Loss?
Conductive hearing loss can mirror some of the same general symptoms as above.
However, due to the nature of this type of hearing loss, there are a few other things to watch out for.
According to the American Academy of Otolaryngology-Head and Neck Surgery, symptoms of conductive hearing loss could include:
- Ear pain or tenderness
- A gradual loss of hearing
- Fluid drainage from the ears
- The feeling of stuffiness or fullness in the ears
Common Causes of Conductive Hearing Loss
As stated above, conductive hearing loss occurs when sound waves cannot reach the inner ear.
This complication results from issues within the outer and middle ear. Below are some common causes of hearing loss.
- Earwax buildup (cerumen). Earwax impaction is a common culprit of conductive hearing loss. Heavy ear wax builds up over time and can clog the outer ear up to the eardrum. If the impaction is bad enough, it won’t allow sound to pass through the middle ear.
- Ear infections. Middle ear infections (otitis media) are another common cause of conductive hearing loss. Infections in the ear canal, like Swimmer’s ear (otitis externa), are another potential cause. Infections cause inflammation and fluid buildup, hampering sounds from reaching the inner ear.
- Obstruction by a foreign object. A small foreign body can get stuck in the ear canal and cause conductive hearing loss. While it can happen to anyone of any age, conductive hearing loss due to ear canal obstruction is much more common in small children.
- Trauma to the middle ear. The middle ear houses an important set of small bones known as the ossicles. This chain of bones is integral for transmitting sound waves to the inner ear. The sound cannot reach the inner ear when there is a break in the connection between them due to injury or trauma.
- Ruptured eardrum. A ruptured eardrum, also known as tympanic membrane perforation, is essentially a hole or tear in the thin tissue that separates the ear canal and the middle ear. This can result from sudden changes in pressure, exposure to loud noises, or simply poking the eardrum with sharp objects.
Some other causes of conductive hearing loss include:
- Microtia and atresia: deformities and malformation to the outer ear and ear canals.
- Blockages of eustachian tubes, which connect the middle ear to the back of the throat/nose.
- Abnormal growths like tumors cause dysfunction in the middle ear.
- Stenosis (narrowing) of the ear canal.
- Otosclerosis is caused by the stapes (bones in the middle ear) becoming stuck in place.
- Cholesteatoma, or an abnormal collection of skin cells deep inside the ear.
What Are Treatment Options for Conductive Hearing Loss?
Treatment for conductive hearing loss depends on the cause of the hearing impairment. The best action is to visit a healthcare provider for medical advice and a treatment plan. These may include:
- Physical examination to check for abnormalities, blockages, infections, and more.
- An audiogram (hearing test) to generate a graph that looks for specific indications of conductive hearing loss — dB loss, frequencies, pitches, etc.
- A Rinne hearing test to help distinguish the sounds being transmitted through bone conduction from sounds being transmitted through air conduction. This test helps detect conductive hearing loss in one ear at a time.
- A Weber hearing test that can help detect both types of hearing loss, conductive and sensorineural hearing loss, in each ear.
Conductive hearing loss is a type of hearing loss that doesn’t allow sounds to reach the inner ear. It can have various causes, from trauma, infection, obstruction of the ear canal, or simple earwax buildup.
Thankfully, the prognosis for recovering from conductive hearing loss is usually good.
If you suspect conductive hearing loss make sure to reach out to an audiology professional who can diagnose the issue and offer treatment options.
For more articles on different types of hearing loss and what you can do about hearing loss, explore the rest of the USA Rx blog here.