Conductive hearing loss

Conductive hearing loss (CHL) is a form of deafness that can impair the quality of life of patients to a great extent. Read and find out all about the condition, including its various causes, symptoms, diagnosis and treatment options.

Conductive hearing loss Definition

CHL is one of the three types of hearing loss, the other two being Sensorineural hearing loss and Mixed hearing loss. It is a form of deafness that occurs as a result of some problem in the ability of the ear to conduct audio waves.

The condition generally involves a decrease in audio level or the ability to hear faint noises. The disorder is also referred to by other names like Conductive Deafness (CD) and Transmission Deafness.

Conductive hearing loss ICD9 Code

The ICD9 Code of this disease is 389.0.

Conductive hearing loss Prevalence

This is a rare condition as compared to the other two types of loss of hearing. Sensorineural hearing loss, in which the problem lies with the auditory nerve or the cochlea, account for much as 90% of all cases of deafness.

Conductive hearing loss Symptoms

Although not generally distorted, audio sensations turn quieter for patients of this type of deafness. Based on the underlying cause, the condition can be either permanent or temporary. Sounds get muffled on account of the defect in the inner, middle or outer ear. Sounds cannot travel to the auditory nerve through the ear.

This form of deafness can arise alone or in conjunction with Sensorineural hearing loss.

Conductive hearing loss Causes

The disease generally arises when energy in sound waves is not efficiently conducted to the eardrum and the ossicles (tiny bones) of the middle ear through the outer ear canal. The kinetic energy of the audio waves are not delivered to the middle ear organs, such as the cochlea. Hence, they cannot be converted into electrical energy in the form of neurological impulses that are sent along the auditory nerve and all the way to the brain.

A mechanical problem in the middle or outer ear is the chief reason for this condition. It is not known why this problem occurs. However, some possible causes have been reported by physicians and medical researchers. These include:

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

Conductive hearing loss Risk Factors

No particular risk factors have been identified for this condition. However, researchers and doctors have mentioned some factors that may damage the ear in some way. These include:

Heredity

The genetic makeup of an individual may make him or her more prone to ear damage.

Ageing

Increase in age can lead to a natural deterioration in the number of cells and reduce the capability to hear sounds. Due to this reason, older people are at greater risk of suffering from loss of hearing.

Occupational noises

Being engaged in professions that require individuals to be exposed to loud noises over many years can increase susceptibility to CHL. These include jobs such as sandblasting, repairing of automobiles, producing music or manufacturing fireworks.

Certain ailments

Conditions that cause high fever, such as Meningitis, may result in damage to the tube-shaped structure in the inner ear known as Cochlea and lead to deafness.

Use of some medicines

Some medications, such as chemotherapy drugs and antibiotics like Gentamicin may cause damage to the inner ear. In case of intake of loop diuretics, pain-relievers, high doses of Aspirin or anti-malarial drugs, hearing problems may occur.

Conductive hearing loss Diagnosis

The diagnosis of this condition may begin with a physical examination of patients and analysis of their medical history.

The diagnostic exams for this disorder include:

• MRI scan or CT scan of the head (in case a fracture or tumor is suspected)
• Tympanometry
• Audiometry (a hearing test that is used to determine the type and amount of deafness)

Conductive hearing loss Differential Diagnosis

The differential diagnosis of this condition can be a challenge as the signs and symptoms of CHL can be quite similar in nature to those of the two other types of hearing loss. Doctors, therefore, should take steps and perform all necessary steps to ascertain that patients are not suffering from Sensorineural hearing loss or Mixed hearing loss.

Conductive hearing loss Treatment

This kind of deafness can often be corrected surgically or medically. CHL can present both some of the simplest and some the most complicated cases of loss of hearing to cure for doctors.

The types of CHL arising due to factors like failure of the ear canal to open at birth or congenital absence of ear canal may possibly be cured by surgical means. If operative techniques fail to improve hearing abilities, use of a conventional hearing aid, surgical implantation of an osseointegrated device or amplification with a bone conduction hearing aid can be beneficial.

Cases of CHL occurring due to factors like tumors, trauma or presence of some foreign body can be cured with antifungal drugs or antibiotic medicines. Chronic non-infectious middle ear fluid is cured with pressure equalizing tubes or surgery.

Cases, which arise as a result of head trauma, are frequently found to improve after surgical repair of middle ear structures that might have suffered damage.

Otosclerosis, a genetic form of CHL, is characterized by a bony fixation of the stapes due to which sound sensations cannot reach the middle ear. The condition is generally manifested by loss of hearing in the early stages of adulthood. Surgery can successfully manage the problems associated with this type of CHL by replacing the immobile stapes with mobile stapes.

Long-term hearing loss of this type may be managed with the aid of supportive devices like hearing aids. Sufferers of acute hearing loss may also benefit from use of sign language and other communicative techniques.

In people with severe loss of hearing, use of cochlear implants may be assistive. Listening and communication enhancement, when used along with medical treatment measures for CHL, can maximize the chances of a better prognosis and improve the ability of sufferers to listen to sounds that are available to the brain.

Conductive hearing loss Home Treatment

The home remedial measures for this disorder mainly include flushing accumulated wax out of the ear. Buildup of wax in the ear can be a cause for this disorder. Gently flushing the ear with warm water and ear syringes can be helpful in removing obstructions. If the wax is stuck in the ear and hard in form, wax softeners like Cerumenex may be required.

Patients should go gentle while removing wax or any other foreign object that may possibly be present inside the ear. Sharp instruments should not be used for removal, as they can injure the ears and aggravate the problem.

Conductive hearing loss Prognosis

The outcome of cases of this condition is positive in nature. In many cases, the loss of hearing can be repaired or at least improved with the help of operative techniques. Acute and chronic cases may require some time to be improved. In some cases, use of supportive devices like hearing aids or implants may be used all through life to counter the symptoms of CHL and help patients manage the condition. Those who use hearing aids and other assistive equipments report of vast improvements in their life.

Successful treatment helps dramatically improve the quality of life of sufferers and make them have more self-confidence. They can have an improved approach towards life and have closer relationships with people who love and care for them.

Conductive hearing loss Complications

Loss of hearing can have a negative impact on the quality of life of CHL sufferers. Progressive deafness is a cause for concern and can make a patient dependent on others and suffer from a loss of self-esteem and confidence. The other problems are generally psychological in nature. The commonly reported ones among them include:

• Anxiety
• Depression
• A false assumption of others being angry with him or her

Such problems are mainly reported in patients who are older in age.

Unfortunately, those suffering from CHL and other forms of deafness continue to live with the problem before finally opting for medical treatment. This may cause lasting difficulties for patients as well as their family members. Sufferers may also socially withdraw themselves and reduce interaction with others.

Conductive hearing loss Prevention

The preventive measures associated with CHL involve those recommended for any type of hearing loss. These include:

Having hearing ability tested

Regular hearing tests may be useful in case of aged individuals and those who are regularly exposed to high sounds in their work environment. Going for ear tests on a regular basis can help determine loss of hearing on an early basis. Understanding that some amount of hearing ability has been lost can indicate that steps should be taken on an immediate basis to prevent further deafness.

Protecting ears in workplace

Earmuffs, which are specifically designed as earphones, can be worn to protect the ears by reducing the intensity of noises that the ears can perceive. Earplugs made of foam, rubber, plastic or any similar material can also provide ears with effective protection from loud noises.

Avoiding recreational activities

Avoiding activities like listening to music or playing computer games for long periods, which can cause damage to hearing, can also reduce the risk of CHL. Such activities, even if not altogether avoided, should be reduced to ensure better health of the ears. Turning down the volume of music player or computer/laptop speaker while listening to music or playing games can also help a person prevent damage to his or her hearing abilities.

If hearing loss of patients tends to worsen in intensity and interfere with their lifestyle, professional medical care providers should be contacted at the earliest. As is true in case of most other disorders, timely medical intervention and treatment can help check this disease and prevent any possible complications arising due to this condition.

References:

http://en.wikipedia.org/wiki/Conductive_hearing_loss

http://ghr.nlm.nih.gov/glossary=conductivehearingloss

http://www.wisegeek.com/what-is-conductive-deafness.htm

http://www.asha.org/public/hearing/conductive-hearing-loss/