Conductive Hearing Loss

3 million children under the age of 18 have some hearing loss, including 4 out of every 1,000 newborn infants.

There are 4 types of hearing loss:

  1. Conductive
  2. Sensorineural
  3. Mixed hearing loss
  4. Auditory neuropathy/dysynchrony.

Conductive hearing loss occurs when the outer ear canal and the tiny bones (ossicles) of the inner ear are damaged. This type of hearing loss usually means your child experiences a reduction in sound levels or the ability to hear faint sounds.

This type of hearing loss can often be corrected medically or surgically.

Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. When this occurs, the hearing loss is referred to as a mixed hearing loss.

Patients can be seen by Texas Children's experts in Audiology and Ear Nose and Throat (Otolaryngology) and Speech Language and Learning.

Causes & Risk Factors

Causes include:

  • 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

Symptoms & Types

Symptoms include:

  • Speech and language delay
  • Poor attention
  • Trouble following directions
  • Behavioral problems

Diagnosis & Tests

The doctor will use an instrument (otoscope) with a light attached to look into the ear canal. You will probably be referred to an audiologist, a professional who specializes in diagnosing and treating hearing problems.

Your child may need certain tests. These may include:

  • Tympanometry and acoustic reflex testing: evaluates how the middle part of the ear is working and the possible location in the ear of what is causing the problem.
  • Otoacoustic emissions: measures a response produced by the inner ear (cochlea) and the strength of that response.
  • Auditory brainstem response (ABR): measures how the nerve that controls hearing responds to sound.
  • Pure tone air and bone conduction testing: notes the softest tones your child can hear for different frequencies or pitches.

Treatment & Care

Treatment may consist of:

  • Referral to an ear, nose, and throat doctor (also called an 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 & Managing

Your child will need varying levels of support, depending on the severity of the 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 depending 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 faces additional educational risk due to listening challenges.

Ways you can help your child at home and at school in discussion with the teacher:

  • 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.