Conductive hearing loss
Conductive hearing loss
Description, Causes and Risk Factors:
Conductive hearing loss is the most common cause of hearing impairment - especially in children. The “conductive” component of the problem describes the blockage of sounds from reaching the sensory cells of the inner ear. In conductive hearing loss, the inner ear functions normally, but sound vibrations are blocked from passage through the ear canal, eardrum or across the tiny bones located in the middle ear. Patients with conductive hearing loss hear bone-conducted sounds presented with a small vibrator to the skull better (louder) than sounds presented through earphones.
There are a number of causes but in pre-school children and young school age children conductive hearing loss frequently occurs if the eustachian tube is blocked. The air in the middle ear cavity is absorbed and replaced by fluid which can become thick and `glue-like' (hence the term `glue-ear'). This is an infection known medically as otitis media with effusion (OME). Hearing loss can be present even before fluid builds up and without infection being present. Almost every child under two years will have at least one episode of middle ear infection with conductive hearing loss.
Other Risk Factors:
Injury of the outer ear itself.
Blockage of the ear canal due to cerumen or other small objects like food, beads or insects.
Infections of the outer or middle ear, often with effusion.
Perforation of the tympanic membrane.
Congenital deformities (e.g., Down Syndrome, Franceschetti Syndrome, Treacher Collins Syndrome or Achondroplasia (dwarfism).
Otosclerosis (also termed otospongiosis) is a condition of the inner ear bone. Abnormal changes (`remodeling') of the inner ear bone results in stiffening or fixation of the stapes bone hinder its vibrations. This results in a conductive hearing loss. Otosclerosis will usually affect both ears but is generally worse on one side. It is hereditary in some cases.
Symptoms may include:
Feeling of fullness in the ear.
Sounds are faint or non existent.
Needing everything to be repeated.
Depression and embarrassment.
Tinnitus (a ringing or booming sensation in one or both ears).
Diagnosis of conductive hearing loss is not difficult in the experiencedhands of an audiologist or otolaryngologist.Special hearing test techniques are available to quantify the degree of theconductive hearing loss such as comparing bone-conduction thresholdswith air-conduction thresholds, tympanometry and acoustic reflex measurements, and otoacoustic emissions testing. Your audiologist should useall these techniques to verify and delineate the conductive hearing. Thesetests are more difficult to administer to very young children and requirean experienced audiologist experienced with pediatric patients. There exists considerable debate withinthe medical community as to the best means of treating children who have middle ear fluid and thereis concern that too many unnecessary antibiotics are prescribed for this condition. Pediatricians tendto support medicinal treatment for extended periods of time, while otolaryngologists will often suggestsurgical placement of tiny aeration tubes in the ear drum to immediately ventilate and drain the middleear fluids.
Tests May Include:
Tuning fork test: Testing is done in different frequencies to determine the type of hearing loss.
Pure tone audiometry: An audiometer produces sounds of different volumes and frequencies.
Otoacoustic emissions: Measures your cochlear function and records the signals produced by the hair cells.
Auditory brain stem response: This measures the activity of the cochlea, cochlear nerve, and brain in response to sound.
Whispered speech test: A combination of numbers and letters are whispered behind you.
With conductive hearing loss treatment can be done in a myriad of ways to include:
Softening and removal of excessive earwax. Ear wax should be removed only by someone with proper experience and safe instruments. Do not use Q-tips to remove earwax as this technique generally makes the situation worse by pushing the wax deeper into the ear canal while depositing shreds of cotton fibers from the Q-tip into the wax itself.
Draining of fluids that have built up.
Antibiotics such as oral medication or ear drops.
In severe cases surgery.
Removal of the offending obstruction.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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