Conductive hearing loss occurs when your outer ear, middle ear or ear canal has become blocked or damaged. This can make it hard for sounds to pass effectively from the outer ear to your middle ear.
10%
Conductive hearing loss is less common, affecting only 10% of all hearing loss.
Conductive hearing loss is considerably less common than sensorineural hearing loss, making up just 10% of cases of hearing loss.
Have you ever been on a flight and your ears start to feel clogged? This will have been caused by the sudden change in altitude and the air pressure outside of your body being different from that in your middle ear and Eustachian tubes. The Eustachian tubes are canals located on either side of your face that runs from the back of your nose and upper throat to your middle ear. When the change in air pressure makes your ears feel clogged and your hearing becomes muffled, this is similar to conductive hearing loss linked to Eustachian tube dysfunction. This is one of the common causes of conductive hearing loss.
The anatomy of your ear is made up of:
The outer part of your ear directs sound onto your eardrum (tympanic membrane) and then these sounds are transmitted as vibrations through your middle via small ear bones before finally reaching your inner ear (cochlea).
Conductive hearing loss is usually mild to moderate and makes sounds seem softer. However, when amplified, they can be heard more clearly. You may be able to hear better when you are in a noisy environment because conductive hearing loss reduces background noise that would otherwise interfere with the conversations you want to listen to. If you were to put cotton wool in your ears or wear earplugs, this will be similar to what conductive hearing loss can sound like.
There are several causes of conductive hearing loss from something relatively common as impacted ear wax to other rarer causes such as cholesteatoma.
Impacted ear wax (cerumen): A relatively common cause of temporary conductive hearing loss, impacted earwax is the build-up of excess wax in your ear. It can be made worse if you try to dislodge the earwax from the ear canal yourself with a cotton bud. The excess wax can stop sound from reaching your inner ear from your outer ear.
Infection of the outer ear (otitis externa): This is an infection of the skin of the external ear canal. When the debris and swelling block the canal it can lead to conductive hearing loss.
Squamous cell carcinoma: Squamous cell carcinomas of the temporal bone is the most common cancer of the external ear canal and usually affects people in their 50s and 60s. Discharge from the ear is the main symptom, while earache, bleeding and conductive hearing loss are also quite common.
Blocked Eustachian tube: The Eustachian tube links the back of your nose to the middle ear. You may experience Eustachian tube dysfunction when there is swelling to the mucosal tube lining or the tube is unable to open or close correctly. It’s common to experience temporary dysfunction during flights or when you have a head cold or fluid in the ear (swimmer’s ear).
Perforated eardrum: Trauma or infection in the ear can lead to a hole developing in your eardrum. This can cause you to have reduced hearing in the affected ear. Inserting something like a cotton bud too far into your ear, exposure to very loud noises (noise-induced hearing loss), head trauma, blow to the ear or changes in air pressure (barotrauma) that occur during a flight or while scuba diving can cause a perforated eardrum.
Infection (otitis media): Inflammation can affect your middle ear. Chronic suppurative otitis media is a persistent ear infection that causes perforation or tearing of the eardrum. Otitis media with effusion (fluid in the middle ear) is the most common type associated with hearing loss, vertigo, tinnitus (ringing in the ears) and earache. Otitis media is more common in adults with weakened immune systems.
Otosclerosis: This is a rare, abnormal growth of one of the very small bones located in the middle ear (stapes bone) and stops the structures in your ear working properly. It’s supposed causes are genetic, inflammatory, hormonal and metabolic. It mainly affects peopled aged 15 to 40 and twice as likely to affect women than men. Around 20% of conductive hearing loss cases are attributed to otosclerosis, according to a 2009 study.
Cholesteatoma: More commonly linked with infections, these abnormal, noncancerous skin growths develop behind the eardrum in your middle ear. They often develop as a sac or cyst and linked to chronic ear infections. As the size of the growth increases, it can damage the very delicate bones in the middle ear.
Paraganglioma: Sometimes referred to as glomus tympanicum, this is the most common primary neoplasm of the middle ear. It’s also the second-most-common tumour of the temporal bone. It’s more common for it to affect women in their 50 and 60s. It causes tinnitus (ringing in the ears) but the mass in the middle ear can also stop sound waves passing through the middle ear to your eardrum, causing conductive hearing loss.
Temporal bone trauma: Blunt head injuries (such as from a car accident) can damage the middle ear and eardrum and injure the brain, facial nerves and inner ear. Patients who are conscious following the injury will immediately experience hearing loss and this is often the most common complaint they report after temporal bone trauma. Around 40% of people with head injuries experience hearing loss and tinnitus.
Enlarged adenoids: The obstruction caused by enlarged adenoids can disrupt the normal transmission of sound waves from the middle ear to the inner ear, especially in children. This disruption leads to conductive hearing loss, where sound vibrations are not efficiently transmitted, resulting in a decrease in hearing acuity. In fact, these glands play a crucial role in the immune system, but can sometimes become enlarged or infected. Adenoidectomy involves the complete or partial removal of these adenoids to alleviate symptoms and improve overall health.
Several tests will diagnose conductive hearing loss. Further tests are used to diagnose any underlying diseases that could lead to conductive hearing loss.
Otoscopy: This is a common test used to diagnose conductive hearing loss. It involves your doctor gently inserting an otoscope into your ear so they can examine your ear canal and eardrum. It will help them to determine if there is an injury to your eardrum, a problem in the middle or foreign bodies in your ear canal such as impacted earwax. Your doctor will examine the colour of your eardrum, its translucency to see whether it’s opaque or transparent and its position to see whether it’s bulging, retracted or neutral.
Weber test: This test using a tuning fork which is placed on the crown of your head. You will be asked if the sound is louder in your left ear, right ear or the middle. If your hearing is normal, then you will be able to perceive the sound equally in both ears. However, if you have conductive hearing loss in just one ear, then you will likely hear the sound louder in that affected ear.
Tympanometry: This uses a probe-like device which is placed in your ear to determine if there is any abnormal pressure, fluid or a growth in your middle ear. It will also be used to see if there is any perforation or scarring to your eardrum or any issues with the small bones of your middle ear. The test is very quick and only takes two minutes for each year. However, you cannot speak, move or swallow while the test is being carried out.
Pure-tone audiometry: This test is used to assess the threshold of a person’s hearing and to determine if their hearing falls within or below normal limits.
While sensorineural hearing loss is permanent, conductive hearing loss is often temporary and will resolve by itself or corrected medically or surgically. The treatment for conductive hearing loss will vary depending on the underlying cause.
Impacted earwax: If there is no history of infection, a perforated eardrum or previous surgery to the ear, then warm-water irrigation by a doctor or hearing care professional is a safe method for removing impacted earwax.
Infection of the outer ear: The ear canal is first debrided, ear drops are used in the infected ear. If it is severe infection then a wick is placed in the ear for two to three days to ensure medication is delivered to the affected area. Oral antibiotics may also be prescribed. Your hearing loss should resolve once the inflammation subsides.
Eardrum perforation: If the ear canal is kept dry, then it’s normal for the hole to heal by itself. However, if the ear becomes infected, then oral medication or antibiotic ear drops will be prescribed. If the eardrum still doesn’t heal within two months, then you may require tympanoplasty. This surgery uses different types of grafts to repair the perforation. It’s common for tympanoplasty to be used when there is a chronic infection caused by a perforation.
Infection: Myringotomy is used to release middle ear fluid to allow sound waves to reach your inner ear. During this procedure, a small incision is made through the layers of your eardrum. The fluid is then suctioned from the middle ear through the incision. A sample may be sent to a lab to determine if a virus or bacteria are present. Ventilation tubes are often used to keep the incised eardrum open to help drain the fluid.
If you suspect that you may have conductive hearing loss or have any other concerns about your hearing, then you should schedule a consultation with a hearing care professional as soon as possible. The impact of untreated hearing loss can be devastating and affect all aspects of your health and wellbeing.
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Conductive hearing loss happens when sound cannot pass efficiently through the outer or middle ear. Below is a list of common causes:
Many of these causes can be medically or surgically treated, especially if diagnosed early. Prompt management helps prevent long-term complications, particularly in children where hearing is vital for speech and language development.
Yes, an acute otitis media (a middle ear infection) can cause conductive hearing loss.
Here's why:
In summary:
Yes, otosclerosis is a well-known cause of conductive hearing loss.
Here’s how it works:
Summary:
While Meniere’s disease is primarily associated with sensorineural hearing loss, not conductive hearing loss, it's important to understand how the condition may present and why it can be confused with conductive types.
🔹 1. Hearing Loss in Meniere’s Is Sensorineural
🔹 2. Why It’s Not Conductive Hearing Loss
🔹 3. Symptoms Can Feel Conductive
🔹 4. Accurate Diagnosis Is Key
🔹 5. Treatment Focuses on Inner Ear Management
Otitis externa, also known as “swimmer’s ear,” is an infection or inflammation of the outer ear canal, usually caused by bacteria or fungi. While it primarily affects the skin lining the ear canal, it can also lead to conductive hearing loss when swelling, debris, or discharge physically blocks the passage of sound to the eardrum.
🔹 How It Causes Conductive Hearing Loss
In otitis externa, the ear canal becomes:
This blockage prevents sound waves from reaching the tympanic membrane (eardrum) efficiently, resulting in a temporary reduction in hearing, typically mild to moderate in severity. Since the middle and inner ear are not involved, the inner ear structures responsible for converting sound to nerve signals remain intact—hence the hearing loss is conductive, not sensorineural.
🔹 Common Symptoms of Otitis Externa
Ear pain, especially when the ear is touched or moved
🔹 Treatment and Outlook
Treatment usually includes:
Once the infection clears and the canal opens, hearing typically returns to normal. In summary, otitis externa can cause temporary conductive hearing loss, which is usually reversible with prompt treatment.
This occurs when there is damage to the inner ear (cochlea) or the auditory nerve.
Besides otitis media and otosclerosis:
Key takeaway: Decreased hearing can have many causes—identifying the type and underlying issue is essential for proper treatment and rehabilitation.
If you're experiencing sudden hearing loss and traditional remedies haven’t made a difference, you may be dealing with conductive hearing loss caused by an ear infection. Infections in the outer or middle ear—such as otitis externa or otitis media—can block or disrupt sound transmission, leading to reduced hearing that can appear quickly. While often temporary, this type of hearing loss can become long-term if left untreated. Don’t ignore the signs. If sounds seem muffled, your ears feel full, or you’re struggling to hear conversations, it’s time to take action. Schedule an appointment with one of our certified audiologists for a full evaluation. We offer a complimentary hearing test to help identify whether your hearing loss is conductive and determine the best course of treatment. Taking the next step now could make all the difference in preserving your hearing health.
Hearing loss can be broadly classified into conductive, sensorineural, or mixed types, depending on the part of the auditory system affected.
To diagnose the type of hearing loss, clinicians use air conduction and bone conduction testing during a hearing exam.
The Rinne and Weber tests are quick bedside tuning fork tests used to help differentiate between conductive and sensorineural hearing loss.
🔹 Rinne Test
🔹 Weber Test
✅ Interpretation
If a patient reports:
...this suggests conductive hearing loss in that ear.
These tests are useful screening tools, but should be followed by formal audiometry for accurate diagnosis.
Conductive hearing loss can be temporary or permanent, depending on its cause and how it is treated. It occurs when sound is blocked or reduced as it travels through the outer or middle ear, preventing it from reaching the inner ear effectively.
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Distinguishing between temporary and permanent hearing loss depends on the cause, symptoms, and medical evaluation. Here are key signs and steps to help determine the difference:
An audiogram is a key tool used to diagnose conductive hearing loss. It visually represents a person’s hearing ability by measuring how well they hear different sound frequencies through air conduction and bone conduction.
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Conductive hearing loss affects the transmission of sound through the outer or middle ear, making sounds seem quieter or muffled, but usually not distorted. People often describe it as similar to having a blocked or plugged ear, like when flying or having water trapped after swimming. The hallmark symptom is a reduction in loudness, especially in the low to mid frequencies. Speech may sound soft but still clear if loud enough. Many individuals can still understand what’s being said in quiet environments, but may struggle in noisy settings. Common sensory experiences of conductive hearing loss include:
Because the inner ear and auditory nerve are unaffected, sound clarity remains relatively intact once loudness is restored, such as with hearing aids or medical treatment. In children, signs may include inattentiveness, delayed speech development, or frequent requests to repeat words. If symptoms persist or worsen, a hearing test is essential for diagnosis and to determine whether the cause is temporary or requires medical intervention.
Conductive hearing loss, also known as conduction deafness or conduction hearing impairment, occurs when sound waves are unable to pass efficiently through the outer or middle ear to reach the inner ear. This type of hearing loss typically results in reduced loudness of sounds but usually does not affect clarity. It can affect one or both ears and may be temporary or permanent, depending on the underlying cause.
Conduction hearing impairment is often caused by issues such as earwax buildup, middle ear infections (otitis media), perforated eardrum, Eustachian tube dysfunction, or abnormal bone growth in the middle ear, such as otosclerosis. These conditions interfere with the normal vibration and transmission of sound to the cochlea.
People with conductive hearing disorders may experience symptoms such as:
Unlike sensorineural hearing loss, which involves damage to the inner ear or auditory nerve, conductive hearing loss often has a treatable cause. Management may include medications, earwax removal, surgical repair, or the use of hearing aids that amplify sound.
Early diagnosis and treatment are important, especially in children, as prolonged conductive hearing loss can impact speech and language development. Audiometric testing helps confirm the diagnosis and guide appropriate care.
These involve obstructions or abnormalities in the ear canal that prevent sound from reaching the eardrum. Common examples include:
These affect the eardrum or the small bones (ossicles) responsible for conducting sound to the inner ear. Key conditions include:
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Conductive hearing loss occurs when sound is blocked or reduced as it travels through the outer or middle ear, preventing it from reaching the inner ear. When this hearing loss is described as mild to moderate, it refers to the degree of hearing impairment measured during a hearing test (audiogram).
This level of hearing loss is often temporary and treatable, depending on the cause. Common causes include:
Symptoms may include:
Adults with bilateral conductive hearing loss may experience:
Although the hearing loss is equal or similar in both ears, the individual may not notice it immediately, especially if it develops slowly
Bilateral conductive hearing loss in adults can result from:
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Other causes include:
Parents and caregivers may notice that the child:
Diagnosis typically involves a hearing test (audiometry or tympanometry) and examination by a paediatrician or ENT specialist. Treatment may include watchful waiting, medications, or surgical options like grommet (tube) insertion. With proper care, like kids' hearing aids, most children recover full hearing and continue normal development.
The first step in treating conductive hearing loss is identifying and addressing the underlying cause:
When medical treatment is not effective, surgery may be recommended:
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These are among the most effective options for conductive hearing loss, especially when traditional hearing aids aren’t suitable. They work by bypassing the outer and middle ear entirely, transmitting sound vibrations directly through the skull to the inner ear. Bone conduction devices are ideal for people with:
Common types include bone-anchored hearing aids (BAHAs) and bone conduction headbands. BAHAs require minor surgery to implant a small titanium post behind the ear.
Choosing the best hearing aid depends on the cause and severity of the conductive loss, medical history, and personal preferences. An audiologist or ENT specialist can recommend the most effective solution after a full hearing evaluation.
Yes, hearing aids can help people with conductive hearing loss, especially when medical or surgical treatment is not possible or only partially effective. In conductive hearing loss, sound has difficulty reaching the inner ear due to problems in the outer or middle ear—such as fluid buildup, earwax blockage, or damage to the eardrum or ossicles. However, the inner ear (cochlea) typically functions normally. Hearing aids work by amplifying sound, making it loud enough to overcome the blockage or mechanical issue. Since the inner ear is still capable of processing sound, this amplification is often very effective.
Types of hearing aids used for conductive hearing loss:
In summary, hearing aids are a highly effective solution for managing conductive hearing loss, improving communication and quality of life when other treatments are not suitable or successful.
Bone conduction headphones transmit sound through vibrations on the bones of the skull, bypassing the outer and middle ear and delivering sound directly to the inner ear (cochlea). Because they do not sit inside the ear canal, they leave the ears open to ambient sound and avoid pressure or blockage that traditional earphones can cause. While bone conduction headphones do not prevent hearing loss entirely, they may reduce the risk of noise-induced hearing damage compared to in-ear or over-ear headphones—especially when used at safe volumes. Since they don’t blast sound directly into the ear canal, they’re less likely to cause long-term damage from prolonged high-volume exposure.
Bone conduction headphones are most effective for people with:
Bone conduction headphones are not effective for:
Yes, bone conduction headphones can work for some people with hearing loss, particularly those with conductive hearing loss or certain types of single-sided deafness. Because they bypass the outer and middle ear, they allow individuals with damaged eardrums or ossicles to hear sound through vibration. However, they are not effective for people with sensorineural hearing loss, where the cochlea or auditory nerve is damaged. In such cases, medical hearing aids or implants are more appropriate. For best results, anyone with hearing loss should consult an audiologist before choosing bone conduction devices.
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