Conductive Hearing Loss

In conductive hearing loss, there is a disturbance in the transduction of sound from the air. The patients only hear reduced sounds of everyday life. Therapy depends on the cause and ranges from drug therapy to plastic surgery.

Conductive Hearing Loss

What is conductive hearing loss?

There are two main types of hearing loss. Either the perception of the sound is disturbed or there is a disturbance in the sound conduction. The latter is the case with conductive hearing loss . The phenomenon is also known as middle ear hearing loss. In the broadest sense, this refers to all hearing impairments based on disturbed sound transmission within the outer ear area or the middle ear. See wholevehicles for What are the Meanings of PMS.

In the ear, sound from the air is transformed into an action potential by a mechanical chain consisting of the eardrum, the auditory ossicles and the labyrinth, which can be processed by the nerve fibers. This process corresponds to transduction. Conductive hearing loss is basically a transduction disorder. In the case of sensorineural hearing loss, on the other hand, there are sensory or neuronal disorders. This form of hearing loss is often referred to as inner ear hearing loss.

Conductive hearing loss can have various causes and is now easily treatable. The prevalence of hearing loss requiring treatment is given as 19 percent for Germany. Up to 30 percent of all hearing impairments are said to correspond to conductive hearing loss. Unlike neuronal sensory hearing loss, conductive hearing loss usually does not manifest itself in old age, but in much earlier decades of life.


The causes of disturbances in the sound conduction in the sense of a conductive hearing loss are variable. Possible causes are, for example, malformations of the auricle, as they occur in congenital form and are often present in the context of malformation syndromes. The primary cause of such congenital malformations is sometimes most often a genetic mutation. Malformations of the ear canal can also cause conductive hearing loss.

This phenomenon also accounts for some malformation syndromes and can be genetically caused. Acquired conductive hearing loss, on the other hand, is often caused by a clot of cerumen or a foreign body in the ear canal. These forms of hearing loss are just as reversible as conductive hearing loss caused by an ear canal infection.

Conceivable causes of acquired forms are also tubal occlusion and middle ear effusion in the sense of a tympanic effusion. Conductive hearing loss is irreversible after scarring in the middle ear or distortion of the auditory ossicles, as can result from injuries such as a skull fracture.

Conductive hearing loss can also be due to a hole in the eardrum or a tear in the eardrum. Other possible causes are otosclerosis, otitis media and cholesteatoma.

Symptoms, Ailments & Signs

Patients with any type of conductive hearing loss hear worse. They perceive all noises in everyday life to be much quieter than healthy people. For example, many patients with conductive hearing loss find conversations strenuous for this reason, as they have to concentrate extremely to perceive. The quality of the sounds does not play a role in conductive hearing loss.

Patients perceive both high and low tones at reduced volume. In many cases, those affected describe the conductive hearing loss with the subjective feeling of hearing through cotton wool or a similar barrier or of wearing earplugs in the ears during the hearing process.

Which symptoms accompany the hearing loss depends on the cause of the conductive hearing loss in the individual case. For example, when there is inflammation, there is pain. In the case of congenital malformation syndromes, the conductive hearing loss in the context of a malformed auricle can be associated with many other malformations of the body.

Diagnosis & course of disease

To diagnose conductive hearing loss, an otoscopy is performed, which can show injuries to the eardrum, earwax or other foreign bodies in the ear canal and phenomena such as middle ear effusion. In addition, a Weber test takes place. The doctor strikes a tuning fork and places it on the crown of the patient, who hears the sound louder in the hearing-impaired ear with conductive hearing loss. In addition, a negative Der Rinne test pronounces pathologically negative.

The tympanogram is used to determine the mobility of the eardrum and allows conclusions to be drawn about the pressure conditions in the ear. This examination can detect, for example, a tympanic effusion or a ventilation disorder. In the tone threshold audiogram, disturbances in bone and air conduction can also be distinguished. This test can be used to differentially diagnose conductive hearing loss from sensorineural hearing loss. The prognosis for patients with conductive hearing loss depends on the cause.


People with conductive hearing loss often have to limit themselves considerably in everyday life. It is usually no longer possible to carry out the job and even everyday things such as shopping or having conversations are difficult. The limited hearing ability is accordingly associated with stress, which represents an additional burden for those affected.

Greater complications can occur if the patient is no longer able to hear traffic due to the hearing loss. The accident risk is then increased and many of those affected withdraw as a result and develop mental illness. Conductive hearing loss usually does not cause physical symptoms. However, congenital malformation syndromes can lead to inflammation and other problems in the ear area.

In addition, the cosmetic blemish can promote the development of inferiority complexes. Drug therapy of the disease can have side effects and interactions. Nasal sprays can lead to inflammation of the nasopharynx. Under certain circumstances, the sufferers develop addictive behavior and subsequently suffer from the long-term side effects of the drug in question.

Surgical treatment involves the usual risks: infections, bleeding and wound healing disorders. Even years later, rejection reactions of the skin can occur. Incorrectly adjusted hearing aids occasionally cause further damage to the ear. Inflammation and balance problems cannot be ruled out either.

When should you go to the doctor?

Conductive hearing loss always requires medical treatment. Usually, self-healing is not possible. In the worst case, if left untreated, conductive hearing loss can lead to complete deafness in the affected person. The earlier the disease is detected, the better the further course. A doctor should be consulted if the patient can only hear very poorly. He has to concentrate extremely on the conversation or on certain noises in order to be able to perceive them.

The quality of the sound also decreases significantly. In some cases, a malformation of the auricle can also indicate conductive hearing loss and should also be examined by a doctor. These symptoms can occur especially after accidents or after very loud noises and must be examined by a doctor. Conductive hearing loss can be diagnosed by an ENT doctor. Further treatment depends on the exact cause of the conductive hearing loss, so that no general course can be predicted.

Treatment & Therapy

The treatment of conductive hearing loss depends on the primary cause. Depending on the cause, causal therapies are available for some conductive hearing disorders. This is how foreign bodies in the ear canal can be removed, for example. The cause of the hearing loss is then eliminated and the hearing loss is cured. A disturbance caused by earwax can be therapeutically resolved quickly and manually.

If the ventilation of the tuba auditory is disturbed, conservative medication therapy with decongestant nasal spray takes place and the hearing loss is also healed. A causal tympanic effusion requires a somewhat more complex causal therapy. With an incision in the eardrum, the doctor provides relief and allows the ear secretion to drain. In this case, too, the hearing loss is resolved once its cause has been resolved and the cut heals by itself.

However, if the hearing loss has more serious causes such as otosclerosis or destruction of the auditory ossicles, complex therapeutic procedures are indicated. The treatment in these cases takes place by means of surgical procedures. If the auditory ossicles are destroyed, a stapesplasty or tympanoplasty is performed. Hearing aids can also be used, particularly in the case of congenital conductive hearing loss.


Conductive hearing loss caused by foreign bodies such as earwax can be prevented by regular ear hygiene, for example. Regularly occurring ventilation disorders and effusions can also be prevented by supplying a small tube.


The necessary aftercare measures for conductive hearing loss depend on the causes of the disease and the therapy used. If earwax was removed manually or if the physical triggers of the hearing loss could be treated with medication, no further follow-up care is usually necessary. However, patients who have experienced multiple tympanic effusions in the past may be advised to use tympanostomy tubes.

These allow secretions to drain and thus prevent the accumulation of fluids in the area of ​​the eardrum. Children and young people are particularly affected by this clinical picture. In the case of surgical treatment, for example to correct malformations of the auricle, it may be necessary to observe check-ups individually specified by the doctor.

Temporary measures to protect the surgical wound and prevent inflammation may also be necessary. If the cause of the hearing loss cannot be treated, the patient is usually prescribed a hearing aid. In this case, regular checks of your own hearing and the functionality of the hearing aid are essential.

They ensure that the patient’s quality of life is maintained. Regular visits to the hearing aid acoustician at intervals of three to six months are recommended. If the hearing has deteriorated during this period, the expert readjusts the device. People with statutory health insurance are entitled to a new hearing aid every six years.

You can do that yourself

In addition to ear training, which is guided by therapists, those affected can do a number of things to promote their perception.

It has been scientifically proven that a healthy and balanced lifestyle without stress is also good for your hearing. The spirit can participate in conversations more concentrated. In addition, patients with conductive hearing loss should consciously schedule rest breaks. The auditory cells can then regenerate and are receptive to new sound experiences. Loud environments, such as those found on busy streets or at concerts, must be avoided at all costs. The increased sound pressure level has been proven to damage hearing.

Persons with sensitive hearing should avoid certain risks in advance. In winter, for example, ear protection is advisable so that cold drafts do not cause inflammation. When visiting a swimming pool, a swimming cap should keep possible bacteria away from the inner ear. Furthermore, cotton swabs have no place in the ear. Earplugs should also not be pressed too deep into the ear canal.

The named self-help measures cannot restore hearing ability. However, they ensure that those affected retain their sensory perception. The hearing aid becomes a constant companion at work and in everyday life.