How the ears operate is a miracle of design, and their role in keeping us connected and informed about the world around us is admirable. However, diminished hearing capacity causes frustration and becomes burdensome. Conductive hearing loss is one way that our capacity to hear the world around us becomes limited. To raise awareness of the various forms of hearing loss, I invite you to take a closer look at this common type and its treatment options.

Conductive Hearing Loss Symptoms

Reduction in sound clarity is the most notable symptom of conductive hearing loss, according to the University of California, San Francisco Health. Patients suffering from this condition complain that various sounds, even their own voice, seem to be far off in the distance, unclear, or muffled. Some additional symptoms include sensations of increased pressure or pain in the ears. The cause of these symptoms relates to a specific form of hearing function impairment.

The Hearing Function

For us to hear, sound waves from the air pass through the hearing pathway to our brain for processing. There are three basic sections responsible for transmitting sounds to our brain included within the auditory system, including:

• Outer Ear. The design of the outer ear helps trap sound waves from the air around us and funnels them into the ear canal, where they begin a journey through the hearing pathway lasting about 1/20 of a second.
• Middle Ear. After passing through the ear canal, sound waves encounter a thin cone-shaped barrier called the tympanic membrane (eardrum), separating the outer and middle ear. Like the surface of a drum, sound waves striking the eardrum causes it to vibrate, which activates three tiny bones within the tympanic cavity, reacting in sequence to transmit the vibrations to the inner ear.
• Inner Ear. Sound vibrations enter a maze of semicircular canals known as the cochlea in the inner ear. The hair-like nerve endings in this structure convert the vibrations into electrical signals, which the auditory nerve system transfers to the brain. The brain processes these signals into recognizable sound.

When sound waves cannot navigate from the outer ear to the inner ear due to some type of obstruction or “conductive” impediment, conductive hearing loss is the diagnosed condition.

Causes of Conductive Hearing Loss

When conductive hearing loss is the diagnosis, several underlying causes are leading to the loss of the conductive function along the hearing pathway. Causes can be relatively minor and easy to correct or more serious, requiring more complex treatments. Typical conductive hearing loss causes include:

• Cerumen Obstruction (an excessive buildup of earwax in the ear canal)
• Inflammation from Illness or an Ear Infection
• An Eardrum Rupture or Perforation
• Cysts, Tumors, or Growths in the Ear Canal
• Damaged Middle Ear Bone Structures

Treatments for Conductive Hearing Loss

Treatment options for conductive hearing loss can be as simple as wax removal or the removal of a cyst, tumor, or growth in the ear canal to more complex procedures and treatments associated with the middle and outer ear structures. Inflammatory-caused hearing loss can include medications or the insertion of tubes to assist with drainage. Hearing aids or other amplification devices to help boost sound waves through the hearing pathway are also options used by audiologists to treat conductive hearing loss.

I encourage individuals with symptoms, such as unclear or muffled sounds, the sensation that their own voice seems far in the distance, who feel like their ears are plugged up, or are experiencing chronic ear pain, to come in for a hearing exam. With a painless, non-evasive hearing exam, I can find the problem and apply any of a variety of treatments to help correct conductive hearing loss.

Contact us to learn more about conductive hearing loss and the treatment options available at Alabama Hearing Associates in one of our North Alabama or Tennessee Valley clinics.

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Dr. Susan Sheehy

Dr. Sheehy earned her bachelor’s and master’s degrees in audiology at the University of Alabama before beginning her career as a clinical audiologist in Huntsville. In 2005, she received her doctorate in audiology from Salus University. Dr. Sheehy is one of a specialized subset of audiologists certified in tinnitus retraining therapy (TRT). By appointment from the governor, she has served as a member and chairperson of the Alabama Board of Examiners in Speech-Language Pathology and Audiology.
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    Most hearing aids automatically come with wireless streaming from smartphones and it has been a lifesaver for those that are working remotely and spending hours on teleconferences. As for other wireless accessories, the two most popular solutions are a small microphone used in less-than-ideal listening environments and a TV streamer that streams the TV’s sound directly into your ears—which can be a lifesaver when watching British TV shows or during football season. If your audiologist believes they would be beneficial for you, they will discuss your options and demonstrate the device in the office.

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    “Having a detailed orientation can dramatically improve how much success you have with hearing treatment.  Counseling & Follow-up care can also ensure that you have success for years to come.  Regular visits to a hearing care provider who spends the time to discuss treatment related information and who will maintain your devices is extremely important.”

    During the orientation, your provider will give you the tools you need to be a successful hearing aid user. Everyone has different learning styles and we want to make sure whatever works best for you is what’s used. After the 75 day adjustment period, routine checkups are necessary to maintain the hearing aids and to ensure optimal hearing healthcare. 

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    Ears are as unique as a fingerprint. Because of this, every ear will collect sounds differently.

    Even if I had two patients with the exact same hearing loss and hearing aids, there’s almost no chance the hearing aids would be programmed the same way.

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    Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. The most sensitive quality control measure is something called Electroacoustic Analysis. We complete EAA on every new set of hearing aids, before delivery of repaired devices, and on an annual basis.

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    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.