Conductive Hearing Loss

Conductive hearing loss (CHL) happens when sound has difficulty traveling through the outer ear and middle ear. This can be caused by ear wax, ear infections, fluid or abnormal structures of the ears. This hearing loss can typically be treated by medicine or surgery. 

Common Causes

• Fluid in the middle ear from colds
• Ear infection (otitis media)
• Allergies (serous otitis media)
• Poor eustachian tube function
• Perforated eardrum
• Benign tumors
• Impacted earwax (cerumen)
• Infection in the ear canal (external otitis)
• Presence of a foreign body
• Absence or malformation of the outer ear, ear canal or middle ear

Risk Factors in children

• Recurrent or chronic ear infections
• Enlarged adenoids
• Craniofacial abnormalities (e.g., cleft palate)
• Frequent upper respiratory infections
• Exposure to secondhand voice
• Daycare attendance, which may increase infection exposure

Symptoms

• Speech and language delay
• Poor attention
• Trouble following directions
• Behavioral problems
• Reduced or muffled hearing

Diagnosis and Tests

A health care provider will look inside your ear with an otoscope, a small tool with a light. This helps them check for problems such as earwax buildup, infection, fluid in the ear, or damaged eardrum.

Your child may need hearing tests that include:

• Tympanometry and acoustic reflex testing checks how well the middle ear is working and helps identify where the hearing problem may be located.
• Otoacoustic emissions (OAE) measures how well the inner ear (cochlea) responds to sound.
• Auditory brainstem response (ABR) checks how the hearing nerve and brain respond to sound.
• Pure tone air and bone conduction testing finds the softest sounds your child can hear at different pitches.

Treatment and Care

Treatment may consist of:

• Referral to an ear, nose, and throat doctor (also called otolaryngologist) for medical or surgical management or both
• Hearing aids for children whose hearing loss cannot be medically or surgically corrected.
• Speech and language therapy

Living and Managing

Your child will need varying levels of support, depending on the severity of hearing loss. Typical support includes:

• An FM system (a type of wireless system) along with hearing aids to hear better in noisy places
• Tutoring in certain subjects in school depends on your child's ability

You can help your child develop better speech and listening skills. For example:

• Repeat words and expand your child's vocabulary by introducing new words ("terrific" instead of "wonderful").
• Play listening games ("I hear the telephone ringing" or "Is that the front doorbell ringing?").

Your child could face additional educational risks due to listening challenges. You can help your child at home and at school in discussion with the teacher in ways such as:

• Learn about typical language development so you will be able to more easily notice if your child seems to be behind.
• Get your child's attention before you talk.
• Talk to your child on the side of the normal hearing ear.
• Make eye contact when talking.
• Be aware of your child's listening environment. For example, when talking, turn down the television.