Best Practices Checklist

Conductive Hearing Loss | Second Most Common Type of Hearing Loss

By: Dr Cliff Olson
January 25, 2020
Video Transcript

There are 3 different types of hearing loss.  A Sensorineural Hearing Loss, a Conductive Hearing Loss, and a Mixed Hearing Loss which is a combination of the two.  To understand any of these hearing losses, we have to understand how the ear works.The outer ear contains the pinna and the ear canal. The middle ear contains the eardrum, the 3 middle ear bones also known as ossicles, the middle ear space, and the Eustachian tube. The inner ear contains the Cochlea, otherwise known as our hearing organ, the 3 Semicircular canals that control balance, and the auditory and vestibular nerves that send information from the ear to the brain.  Sound, which is a vibration, passes through the ear canal and vibrates the eardrum.  That vibration then moves through the 3 middle ear bones to the cochlea, where this vibration is converted into a neural signal, that is then sent up the auditory nerve to the brain.  A Sensorineural hearing loss occurs when the inner ear is not functioning normally.  However, a Conductive hearing loss is when the vibration of sound is impeded somewhere in the outer or middle ear, preventing it from reaching the inner ear at it’s full intensity.  Which is exactly why it is called a conducive hearing loss, because sound cannot be conducted effectively through this entire pathway.  Conductive hearing losses can be caused by things like Earwax, Foreign bodies in the ear canal, or even Aural Atresia which is the absence of an ear canal.  They can also be a result of problems with the middle ear with a hole in the eardrum, fluid in the middle ear, Eustachian Tube Dysfunction, Otosclerosis, or even Ossicular Chain Discontinuity.When diagnosing a conductive hearing loss, a hearing care professional will look on your audiogram for what is called an Air Bone Gap, which is caused by the difference between sound traveling to your inner ear only vs. through your Outer, Middle, and Inner ear together.  The X's and O's on your audiogram represent your hearing sensitivity as sound passes through all 3 parts of the ear.  The Angle and Square Brackets represent your hearing sensitivity when sound stimulates the inner ear only.  If there is no gap, you do NOT have a Conductive Hearing loss.  If there IS a Gap, then you likely do have a Conductive Hearing Loss.   Treatment for a conductive loss may require earwax removal by curette, suction, or irrigation.  For a foreign body, removal by forceps or surgery and an outer ear infection may require medication from a physician.  For middle ear conditions like fluid buildup, you may require a Myringotomy which is where a tiny incision is made in an ear drum to relieve pressure and to drain fluid.  For conditions like otosclerosis or ossicular chain discontinuity, surgery may be required to address the dysfunction of the 3 middle ear bones.While traditional hearing aids may be a viable treatment option for conductive hearing losses, Bone Anchored Hearing Aids may be a more ideal option because they are designed to bypass the outer and middle ear and stimulate the inner ear directly.  For more information, check out the following videos:How Bone Conduction Hearing Aids Work: Bone Conduction Hearing Aid: the end of the day, identifying the correct type of hearing loss that you have is extremely important.  It is also the reason why you shouldn't take online hearing tests because it is literally impossible to tell which type of hearing loss you actually have which is critical for receiving the correct treatment.  So if you have any concern that you may have a hearing loss, get your hearing tested right away because the longer you go with an untreated Conductive Hearing loss, the worse it can get.

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