What is Conductive Hearing Loss?

When we talk about hearing loss, we often divide it into three main categories: sensorineural, conductive, or a mixed combination of both. In this article, we’ll focus on conductive hearing loss—what it means, what causes it, and how we help our clients understand their results in simple, clear terms.

What does “conductive” mean?

Conductive hearing loss happens when sound cannot travel efficiently through the outer ear or middle ear to reach the inner ear (the cochlea). Think of it as a blockage or disruption in the sound pathway, rather than an issue with the inner ear itself.

Because of this, sounds may seem quieter, muffled, or blocked. The good news is that conductive hearing loss is often treatable or manageable, depending on the cause.

Common causes of conductive hearing loss

• Earwax build-up (cerumen) – a very common and often temporary cause.

• Middle ear fluid (“glue ear”) – especially in children, but adults can experience this too.

• Ear infections – Ear infection which can be in the outer, midedle or inner ear

• Perforated eardrum – a hole or tear in the eardrum can affect hearing.

• Otosclerosis – a condition where the tiny bones in the middle ear become stiff and less able to transmit sound.

• Foreign bodies or structural issues – sometimes related to past surgery, trauma, or congenital differences.

When referral is needed

While some causes of conductive hearing loss are temporary and can be treated (such as earwax build-up), there are occasions where further medical assessment is required. At Somerset Hearing, if we suspect one of these conditions, we will make a referral to your GP or an ENT specialist:

• Persistent middle ear fluid (chronic glue ear) – especially in adults, where it can sometimes be linked to nasal or sinus issues.

• Perforated eardrum that does not heal naturally – which may need surgical repair.

• Otosclerosis – abnormal bone growth in the middle ear that may require specialist treatment.

• Cholesteatoma – an abnormal skin growth in the middle ear that can cause serious complications if untreated.

• Recurring or chronic ear infections – which may require medical investigation or surgery.

• Unexplained single-sided conductive loss – particularly if sudden or accompanied by other symptoms such as tinnitus, dizziness, or ear pain.

  
  

Your audiologist is trained to recognise when your hearing test results or ear examination suggest that referral is the safest next step.

Understanding your hearing test

At Somerset Hearing, every client receives a full hearing test following British Society of Audiology (BSA) guidelines. This includes:

• Air conduction testing – measuring how well sound travels through the entire ear system.

• Bone conduction testing – bypassing the outer and middle ear to test the inner ear directly.

• Tympanometry – checking middle ear function, such as fluid or pressure problems.

On an audiogram (your hearing test chart):

• Conductive hearing loss typically shows as a gap between the air conduction results (often poorer) and bone conduction results (often better).

• This “air-bone gap” is a clear marker of conductive loss.

We provide every client with a detailed hearing report so you can see exactly what type of hearing loss you have, explained in plain English, not just numbers and graphs.

Here is an example audiogram:

• Right ear (red) – Conductive hearing loss (big gap between air and bone results).

• Left ear (blue) – Mixed hearing loss (some gap, but bone is also below normal).

Air symbols = O / X  Bone symbols = [ ]A gap between air and bone shows sound isn’t passing well through the outer or middle ear.

What does this mean for you?

If you have conductive hearing loss, the next steps depend on the cause. Sometimes, simple treatment like earwax removal can restore hearing immediately. In other cases, medical treatment or surgery may be required, and we will refer you to your GP or an ENT specialist if necessary.

For some people, hearing aids can be a very effective way to overcome conductive hearing loss, especially when medical solutions aren’t available or sufficient.

Closing thoughts

Understanding the type of hearing loss you have is the first step in finding the right solution. At Somerset Hearing, we pride ourselves on taking the time to explain your results, your options, and supporting you every step of the way.

If you suspect you may have conductive hearing loss, or if your ears just don’t feel right, why not book a hearing test with us?

Glossary of Key Terms

• Audiogram – A chart that shows the results of a hearing test, mapping how well you hear different tones and volumes.

• Air conduction – The pathway of sound through the outer, middle, and inner ear, tested with headphones during a hearing test.

• Bone conduction – A way of testing hearing by sending sound vibrations directly to the inner ear via a small device placed on the skull.

• Air-bone gap – The difference between air conduction and bone conduction results on an audiogram, a sign of conductive hearing loss.

• Tympanometry – A quick test that measures how your eardrum moves in response to pressure, helping detect fluid or blockages in the middle ear.

• Cochlea – The spiral-shaped organ in the inner ear that converts sound vibrations into electrical signals for the brain.

• Otosclerosis – A condition where the small bones in the middle ear become stiff, reducing their ability to pass sound to the inner ear.

• Cholesteatoma – An abnormal growth of skin in the middle ear, which can damage nearby structures if not treated.

• Glue ear – A build-up of fluid in the middle ear that can cause temporary conductive hearing loss, more common in children.

Resources & References

• National Institute for Health and Care Excellence (NICE) – Hearing loss in adults: assessment and management

• British Society of Audiology (BSA) – Recommended Procedures for Pure-Tone Audiometry & Tympanometry

• Action on Hearing Loss (RNID) – Types of hearing loss explained

• American Speech-Language-Hearing Association (ASHA) – Conductive Hearing Loss Overview

• Phonak & Oticon Clinical Insights – Manufacturer data on hearing aid options for conductive and mixed hearing loss.

• Peer-reviewed literature such as International Journal of Audiology and Ear & Hearing on diagnosis and management of conductive hearing loss.

Written and reviewed by Jon Cade, Director & Audiologist, Somerset Hearing