Key Takeaways
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Conductive hearing loss occurs in the outer or middle ear and often results from blockages or damage.
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Many causes are temporary and treatable, like earwax or infections, though some cases may require surgery or hearing aids.
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Diagnosis usually includes hearing tests like air and bone conduction exams.
What Is Conductive Hearing Loss?
Conductive hearing loss occurs when sound cannot efficiently travel from the outer ear to the inner ear. It often involves problems in the ear canal, eardrum, or tiny bones of the middle ear (ossicles). This type of hearing loss doesn’t affect how the inner ear processes sound — it just prevents sound from reaching that point effectively.
People with conductive hearing loss often say they can hear, but everything sounds much quieter. In many cases, this hearing loss is temporary and treatable, depending on the cause.
Causes of Conductive Hearing Loss
Conductive hearing loss has many causes, which typically fall into two main categories: issues in the outer ear and those in the middle ear.
Outer Ear Causes
The outer ear includes the visible ear and the ear canal. Blockages or structural abnormalities in this area can significantly reduce the volume of sound that reaches the middle and inner ear.
Common causes in the outer ear include:
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Earwax buildup: One of the most common and treatable causes. Impacted wax can block sound from reaching the eardrum.
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Swimmer’s ear (otitis externa): This infection of the outer ear canal causes swelling and fluid buildup, muffling sound.
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Foreign objects: Small items accidentally lodged in the ear canal — especially common in children — can block hearing.
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Ear canal malformations: Congenital conditions like atresia (absence of the ear canal) or stenosis (narrowing) can cause hearing issues from birth.
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Bony growths (exostoses): These benign lumps in the ear canal can obstruct sound and are often linked to frequent cold-water exposure (hence the nickname “surfer’s ear”).
Middle Ear Causes
The middle ear includes the eardrum and three tiny bones (ossicles) that vibrate to transmit sound to the inner ear. When this system is disrupted, conductive hearing loss can result.
Middle ear causes include:
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Fluid in the middle ear: Often seen in children, this can result from allergies, colds, or Eustachian tube dysfunction.
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Ear infections (otitis media): These can cause swelling and fluid buildup behind the eardrum, impairing movement.
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Perforated eardrum: A hole in the eardrum, caused by infection or trauma, reduces its ability to capture sound.
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Otosclerosis: This condition causes abnormal bone growth around the stapes (one of the ossicles), leading to progressive hearing loss.
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Cholesteatoma: A noncancerous skin growth that can develop behind the eardrum, damaging middle ear structures.
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Trauma or ossicle damage: Accidents, head injuries, or chronic infections can harm the tiny bones, disrupting sound conduction.
Understanding the exact cause of conductive hearing loss is key to determining the appropriate treatment.
Symptoms of Conductive Hearing Loss
The symptoms of conductive hearing loss differ slightly from those of sensorineural hearing loss. Because the inner ear remains unaffected, people with conductive loss often report that sound is simply softer but not distorted.
Common symptoms include:
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Reduced hearing, especially for soft sounds
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Pain (if an infection or injury is involved)
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A foul smell or drainage from the ear (in cases of infection)
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Your own voice sounding unusually loud or different (called autophony)
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Improved hearing when turning up volume — like on a phone or TV
These symptoms can occur in one or both ears, and they may come on suddenly or develop over time.
Diagnosing Conductive Hearing Loss
To diagnose conductive hearing loss, hearing professionals typically use a combination of:
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Otoscopy: A visual exam to check for wax, infection, or structural issues.
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Tympanometry: Measures how the eardrum moves in response to pressure changes.
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Audiometry tests: These assess how well you hear sounds at different pitches and volumes.
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Bone vs. air conduction testing: These help determine where the hearing problem is located — whether in the outer/middle ear (conductive) or inner ear (sensorineural).
A bone conduction test is especially useful for identifying conductive loss. If your bone conduction results are normal but your air conduction results are poor, it strongly suggests conductive hearing loss.
Is Conductive Hearing Loss Permanent?
It depends on the cause. Many cases — such as those caused by earwax, swimmer’s ear, or fluid buildup — are temporary and resolve with treatment. Others, like congenital malformations or ossicular chain damage, may be permanent without medical or surgical intervention.
The good news is that even permanent conductive hearing loss often responds well to hearing aids or bone-anchored hearing devices. These options amplify sound or bypass the damaged part of the ear entirely.
Find the Right Hearing Aid for You
Even if your hearing loss is permanent, the right hearing device can restore clarity and connection. Explore hearing aid models tailored to different needs and budgets.
Treatment Options for Conductive Hearing Loss
Treatment depends on the specific cause. The first step is a professional evaluation to determine what’s blocking or disrupting sound.
Possible treatments include:
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Earwax removal: Done at home (with guidance) or by a healthcare provider.
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Medications: Antibiotics or antifungals can treat infections like swimmer’s ear or otitis media.
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Surgery: Procedures like tympanoplasty (repairing a perforated eardrum) or ossiculoplasty (rebuilding damaged bones) may be needed.
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Hearing aids: These can amplify sound if surgery or medical treatment isn’t possible.
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Bone-anchored devices: Especially helpful if the ear canal or middle ear is severely damaged or malformed.
Consulting an audiologist or ENT (ear, nose, and throat) specialist is key to finding the right solution.
FAQs About Conductive Hearing Loss
How do I know if I have conductive hearing loss?
If your hearing feels muffled but improves when you increase the volume or unblock your ear, it could be conductive loss. Only a hearing test can confirm it.
Can conductive hearing loss go away on its own?
Sometimes, yes. For example, fluid from a cold or mild wax buildup may resolve naturally. But if symptoms persist more than a few days, it’s best to get checked.
What’s the difference between conductive and sensorineural hearing loss?
Conductive hearing loss involves the outer or middle ear and is often reversible. Sensorineural hearing loss affects the inner ear or nerves and is usually permanent.
Is conductive hearing loss common?
It’s less common than sensorineural hearing loss but frequently occurs in children due to infections or fluid buildup.
What kind of doctor treats conductive hearing loss?
ENTs and audiologists are typically the go-to providers. They can run tests and recommend treatment or devices based on the cause.
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