Opposite to popular opinion, hearing loss doesn’t only affect the elderly. According to NIDCD, one in eight people aged 12 years and older in the United States experiences difficulty in hearing on both ears, established on approved hearing exams.
This statistic translates to 30 million Americans or 13% of the population. This study also concluded that roughly 15% of adults aged 18 and above in America, reflecting 37.5 million of the American people, claim some difficulty in hearing.
Hearing loss is categorized into three groups:
- Conductive
- Sensorineural
- Mixed
Conductive hearing loss (CHL) develops when the movement of sound gets restricted anywhere along the pathway of the ear: the outer ear, the eardrum, and the middle ear.
Sound waves are prevented from being conveyed to the nerves engaged in the hearing exercise. The movement of sound may be obstructed due to barriers or injured anatomical structures in the middle ear, outer ear, or ear canal. Unlike sensorineural hearing loss, CHL makes sounds seem muffled or muted.
Unlike other hearing disorders that affect both ears, conductive hearing loss may only affect one ear. Dissimilar to sensorineural hearing loss, CHL can frequently be rectified and restored.
Causes of Conductive Hearing Loss
The following factors can cause conductive hearing loss:
- Deformation of the middle ear, ear canal, or outer ear structure commonly noted at birth
- Allergies and colds, leading to the collection of fluids in the middle ear.
- Narrowing of the ear canal
- Thickening of the eardrum(Tympanosclerosis)
- Ossicular chain discontinuity – breakage of the middle ear
- Poor Eustachian tube function leading to the accumulation of liquid in the middle ear and collapsing of the eardrum.
- Perforation or inflammation of the eardrum due to trauma, ear infections, and a dysfunctional Eustachian tube
- Presence of benign tumors that block the outer ear and middle ear
- The collection of cerumen or earwax in the ear canal may block the ear canal leading to hearing loss.
- Infection in the middle ear as a result of the accumulation of fluids (water) interfering with the movement of the ossicles and eardrum (external otitis)
- Foreign objects getting stuck in the ear, which is often in children.
- Otosclerosis (a genetic disorder in which there’s an abnormal fusion of the tiny bone found in the middle ear with bones around it, stopping it from pulsating when excited by any sound.
Signs and Symptoms of Conductive Hearing Loss
For most people hearing loss is gradual and may, therefore, go unnoticed. It is therefore essential to consult a doctor when you notice the following signs:
- Having trouble following a conversation when there is noise in the background
- People protest that you’ve put the TV volume too loud
- Having a stuffy sensation in the ear
- Dizziness
- A foul smell or fluid leaking from the ear canal
- You are always asking people to repeat themselves
- Tenderness, pressure or pain in one or both ears
- Having trouble following a telephone conversation
- Hearing muffled or unclear sounds
- Feeling that your voice sounds louder or strange than usual
- Imbalance
- Difficulty perceiving quiet sounds
Conductive hearing loss is most common in children. CHL in children is usually attributed to otitis media with discharge and may present with strain in hearing, language, and speech delay. In the older population, CHL is a result of ear canal collapse or wax.
In contrast, in the general adult population, it is caused by trauma, an ear infection, otosclerosis, or a tumor.
Diagnosis of Conductive Hearing Loss
Conductive hearing loss might be diagnosed by an audiologist or GP, depending on its cause. Audiologist Heidi Hill has been working in the audiology industry for over 25 years. Diagnosis demands a thorough medical history, physical examination of the throat, ear, neck, nose, and comprehensive hearing tests. A speech test is also done using simple words.
In newborn children, screening is essential for early detection and treatment of hearing loss. The physical examination begins with visualization and palpation of the periauricular and auricular tissues.
A more detailed analysis using a tuning fork, known as the Rinne test and the Weber test, may be necessary if the hearing loss is hereditary.
Management and Treatment of Conductive Hearing Loss
There are several types of CHL. Most instances of CHL are momentary and are managed by employing suitable medical treatment. However, some cases may lead to permanent hearing loss.
Management lapses into three categories: pharmaceutical treatment, surgical, and supportive treatment, determined by the location and character of the cause.
If you’re experiencing hearing loss, you should consult a specialist to evaluate your condition and talk to you about the available treatment options.
1. Surgical Treatment
Conductive hearing loss as a result of the following can be corrected through surgery:
- Perforation of the eardrum
- Dysfunctions of the middle ear caused by head trauma
- Bony lesions
- Cholesteatoma
- Chronic otitis media
- Benign tumors
- Otosclerosis
2. Pharmaceutical Treatment
Ear infections are countered through the administration of antibiotics and antifungal drugs.
3. Supportive Treatment
Medical conditions may not fully reverse conductive hearing loss. In such cases, the use of hearing aids by patients is advised as they improve hearing by the amplification of sound.
The hearing aid may be surgically implanted, bone-anchored, or conventional. The hearing aid depends on the condition of the auditory nerve. The bone-anchored hearing aid is recommended as it delivers sound directly to the cochlea, bypassing the middle and outer ear.
Cases of CHL caused by the impaction of ear wax and foreign objects getting stuck in the ear do not require complex medical procedures. The extraction of wax and the item can quickly rectify the condition. However, if left alone, it may lead to permanent damage.
Prevention of Conductive Hearing Loss
Conductive hearing loss attributed to noise exposure is entirely preventable. Exposure to loud noise can damage the cells that change sound into signals sent to the brain.
The following can help prevent conductive hearing loss caused by exposure to loud noises
- Minimizing your exposure to persistent loud noise.
- Not turning the volume too loud when listening to music using earbuds, earphones or headphones
- Wearing protective earmuffs, earplugs or covering your ears when exposed to loud noise
- Regularly seeing a doctor about a hearing test, to check if you already have some early hearing loss
Regardless of the cause of conductive hearing loss, it is crucial to seek medical attention from hearing experts like Harbor Audiology as early as possible.
