The most common sign that you have conductive hearing loss is that sounds appear quieter, although not distorted. You may find that you need to turn up the volume on your television or ask people to repeat themselves. It can feel like your ears are covered or as if you are wearing earplugs. Other common signs of conductive hearing loss include:

• Struggle to hear conversations, especially during phone calls
• Noticeable difference with hearing in each ear
• Uncomfortable or pressured feeling in your ears
• Your voice sounds different to you
• You need to turn the TV volume up
• You notice a bad smell coming from the ear canal
• Tinnitus (ringing in the ears)

If you experience any of these symptoms then you should schedule a consultation with a hearing care professional or doctor. It may be that you have conductive hearing loss and require treatment, or it may be a sign of some other problem within your ears that requires investigation and treatment.

There are a variety of causes linked to conductive hearing loss which can affect the ear canal or outer and middle ear. These include:

• Earwax (cerumen) that’s become impacted in the ear canal stopping sound reaching the eardrum
• Fluid in the middle ear caused by head colds and allergies
• Perforated (hole) in the eardrum
• Benign tumours that are not cancerous but can block the middle or outer ear
• Poor Eustachian tube function (this connects the middle ear to your nose) causing fluid to not drain out properly, remaining in the middle ear
• Ear infection or otitis media
• Change in altitude during flying, scuba diving or hiking
• Infection in the ear canal or external otitis, also known as swimmer’s ear
• Foreign body in the ear
• Ear malformation
• Squamous cell carcinoma of the temporal bone is a common cancer of the external ear canal (mainly affects people in their 50s and 60s)
• Head injury or a temporal bone trauma which can damage the middle ear and eardrum
• Abnormal growth such as otosclerosis which stops the structures in the ear from working properly

As there are many potential causes of conductive hearing loss, it will need to be diagnosed by your doctor or hearing care professional. They will ask you various questions about your hearing loss, symptoms and other health questions. They will also undertake an examination of your ears and look for any blockage, damage or infection. They may also carry out certain other tests such as:

• Otoscopy: This is a common test which involves your doctor using an otoscope inserted in your ear so they can have a good look of your ear canal and eardrum. It can help identify whether you have a foreign body in your ear canal such as impacted earwax, a problem with your middle ear or you have sustained an injury to your eardrum. Your doctor will also want to examine the colour of your eardrum, its translucency and its position – whether it’s normal, bulging or retracted.

• Weber test: This test uses a tuning fork which is struck first and then put on the crown of your head. As your doctor or hearing care professional strikes the tuning fork, they will ask you to indicate when you hear a sound. You will do this by raising your hand, pushing a button or responding verbally. If your hearing is normal, you should be able to perceive the sound in both ears the same. If you have conductive hearing loss in just one ear, then you will hear the sound louder in that ear.

• Tympanometry: A device similar to probe is put in your ear to check if there’s any fluid, growths or abnormal pressure in your middle ear, scarring or perforations to your eardrum or a lack of mobility in your ear. The test is very short, but you will have to sit very still throughout the assessment and not speak, move or swallow.

• Pure-tone audiometry: This test is used to assess hearing thresholds and will be able to determine whether your hearing levels fall within the normal limits.

Once your doctor or hearing care professional has diagnosed you with conductive hearing loss, they will then recommend the best course of treatment for you, depending on what has caused it.

While sensorineural hearing loss is permanent, in most cases, conductive hearing loss is temporary and will either self-resolve or can be dealt with by treating the underlying condition that’s caused it. Some treatments for conductive hearing loss include:

Impacted earwax

Impacted earwax can be treated with warm-water irrigation as long as you have had no previous infections, injuries or surgery to your ear or experienced a perforated eardrum. It’s generally a safe treatment and best carried out by your doctor or hearing care professional. Never attempt to clear the impacted earwax yourself by using an ear swab or any other object as you risk pushing the wax further into your ear and causing serious damage to your ear and hearing.

Infection of the outer ear

If you have an outer ear infection then your doctor will remove the damaged tissue and apply ear drops. If the infection is particularly severe, your doctor may advise you using a wick which is put in the ear for two or three days and this can help ensure that the medication targets the affected area. You may also be prescribed oral antibiotics.

Eardrum perforation

As long as you keep the ear canal clean, then the perforation should heal on its own. However, if there’s an infection then you may need oral medication or antibiotic ear drops to treat it. You may require tympanoplasty if the eardrum hasn’t healed after two months which will use grafts to repair the hole in your eardrum.

Infection

An infection causing fluid to build up could prevent sound waves from reaching the inner ear. Myringotomy is a surgical incision into the eardrum that releases the fluid and relieve pressure in the ear. A sample of the fluid may also be checked to see if there are any viruses or bacteria present.

When you have completed treatment for your conductive hearing loss, you shouldn’t experience further problems. However, it’s important to continue to monitor your hearing and if you have any concerns or the symptoms of conductive hearing loss return, then contact your doctor or hearing care professional.