Conductive Hearing Loss

Conductive hearing loss occurs when sound is prevented from travelling efficiently through the outer or middle ear to reach the inner ear, due to a physical blockage or problem in this sound-conducting pathway. This differs from sensorineural hearing loss, which involves the inner ear or the nerve pathways to the brain. Conductive hearing loss is often, though not always, treatable, sometimes very effectively, once the underlying cause is identified.

Common causes include earwax build-up, middle ear infections and fluid accumulation (particularly common in children), a perforated eardrum, otosclerosis (abnormal bone growth affecting the tiny bones of hearing), and, less commonly, structural abnormalities present from birth. Identifying the specific cause is important, since treatment approaches vary considerably depending on where exactly along the sound-conducting pathway the problem lies. Many causes of conductive hearing loss are effectively treatable.

Conductive hearing loss involves a physical blockage or mechanical problem preventing sound from reaching the inner ear properly, and is often treatable, sometimes fully reversible, once the specific cause is addressed. Sensorineural hearing loss involves damage to the inner ear's sound-detecting cells or the nerve pathway to the brain, and is generally permanent, though it can often be effectively managed with hearing aids or other devices. This important distinction, often clarified through specific hearing tests, guides very different treatment approaches.

Diagnosis typically involves a physical examination of the ear (looking for wax, infection, or a perforated eardrum), and hearing tests, including tympanometry (which assesses middle ear function) and audiometry, which can help distinguish conductive from sensorineural hearing loss based on the specific pattern of results. Further imaging may be used in some cases, particularly if a structural cause such as otosclerosis is suspected. An ENT specialist or audiologist can arrange the appropriate combination of tests for your specific situation.

Treatment depends entirely on the underlying cause — simple earwax removal, antibiotics for an ear infection, surgery to repair a perforated eardrum or to address otosclerosis, or, for cases where the underlying cause can't be fully corrected, hearing aids or other assistive devices that amplify sound to help compensate. Many causes of conductive hearing loss respond very well to appropriate, targeted treatment. Your ENT specialist will recommend the most suitable approach based on the specific cause identified.

See a doctor if you have hearing loss, particularly if it's sudden, affects one ear more than the other, or is accompanied by ear pain or discharge. NHS ENT or audiology referral can take several weeks; a private consultation is typically available within about 2 weeks for earlier assessment and diagnosis.