- In this video, I'm talking about
the second most common type of hearing loss,
the conductive hearing loss,
coming up!
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Hi, guys, Cliff Olson, Doctor of Audiology and founder
of Applied Hearing Solutions in Phoenix, Arizona.
And on this channel,
I cover a bunch of hearing-related information
to help make you a better-informed consumer.
So if you're into that,
make sure you hit that subscribe button,
and don't forget to click the bell to receive a notification
every time I post a new video.
Generally speaking,
there are three different types of hearing loss.
You have a sensorineural hearing loss,
a conductive hearing loss,
and a mixed hearing loss, which is the combination
between a sensorineural and a conductive.
Now, sensorineural hearing loss is
the most common type of hearing loss,
with conductive hearing losses coming in at second.
But to understand any
of these different types of hearing loss,
we first have to understand how the ear works.
The ear is divided into three sections,
the outer ear, the middle ear, and the inner ear.
The outer ear contains the pinna and the ear canal.
The middle ear contains the eardrum,
the three middle ear bones, also known as ossicles,
the middle ear space, and the eustachian tube.
The inner ear contains the cochlea,
otherwise known as our hearing organ,
the three semicircular canals that control balance,
and the auditory and vestibular nerves
that send information from the ear to the brain.
Sound, which is a vibration,
passes through the ear canal and vibrates the eardrum.
That vibration then moves
through the three middle ear bones to the cochlea,
where this vibration is converted into a neural signal,
that is sent up the auditory nerve to the brain.
A sensorineural hearing loss occurs
when the inner ear is not functioning normally.
However, a conductive hearing loss is
when the vibration of sound is impeded
somewhere in the outer or middle ear,
preventing it from reaching the inner ear
at its full intensity,
which is exactly why it's called a conductive hearing loss,
because sound cannot be conducted effectively
through this entire pathway.
Conductive hearing losses can stem from the outer ear
due to things like earwax,
foreign bodies like cotton left over from a Q-tip,
or even aural atresia, which is the absence of an ear canal.
Conductive hearing losses can also be a result
of a problem in the middle ear,
such as a hole in the eardrum,
fluid in the middle ear space,
eustachian tube dysfunction,
otosclerosis, which is a fusion of the middle ear bones,
or even ossicular chain discontinuity,
which is where the middle ear bones
are not properly connected or aligned.
When diagnosing a conductive hearing loss,
your hearing care professional will look
for what we call an air bone gap.
Here's an example of an air bone gap on an audiogram.
The Xs and Os represent your hearing sensitivity
as sound passes through all three parts of your ear,
including the outer ear, the middle ear,
and the inner ear via air conduction.
The angle and square brackets
on an audiogram represent the hearing sensitivity
of your inner only via bone conduction,
hence the term air bone gap.
If there is no gap between your air
and bone conduction thresholds,
then you do not have a conductive hearing loss.
If you have a significant gap between these thresholds,
then it is likely that you do have
a conductive hearing loss.
When performing a hearing evaluation,
your hearing care professional will typically start
with air conduction testing,
which is what will give us those Xs and Os on the audiogram.
This is where we either place headphones over your ears
or earphones inside of your ear canals
and present beeps that you have to respond to
by either raising your hand or clicking a button.
After air conduction testing,
we typically transition to bone conduction testing
to get the brackets on the audiogram.
This is where we place a bone oscillator
on your skull's mastoid bone behind your ear
and present the same beeps
that we did through the headphones.
This vibration of your mastoid bone
will stimulate your inner ear directly,
completely bypassing the outer and middle ear.
Again, the resulting brackets
on your audiogram represent the hearing sensitivity
of your inner ear only,
where the Xs and Os represent your hearing sensitivity
if sound has to pass through all three parts of your ear.
Now, there are some other tests like tympanometry
that a hearing care professional can use to identify
what is causing your conductive hearing loss,
but that is a topic for an entirely different video.
Okay, now you should have at least a decent grasp
of what a conductive hearing loss is,
so let's go ahead and take a look
at how a conductive loss is treated.
Ultimately, the treatment for a conductive hearing loss
is different than the treatment
for a sensorineural hearing loss,
in that a conductive hearing loss
usually requires medical intervention.
For outer ear causes like earwax,
removal via curette, suction,
or irrigation may be performed.
If there's a foreign body inside of your ear canal,
it may require extraction using forceps
or, for more serious situations, even surgery.
And an outer ear infection may require
medication prescribed by a physician.
For middle ear conditions like fluid behind the eardrum,
you may require medication
and, in some cases, a myringotomy,
which is when a physician will make a tiny, little incision
inside of your eardrum in order to relieve pressure
and drain that fluid.
And for conditions like otosclerosis
or ossicular chain discontinuity,
surgery may be required to address the dysfunction
of the three middle ear bones.
If medical intervention does not completely
correct your conductive hearing loss,
you still have treatment options.
In some cases, traditional hearing aids are enough
to overcome this conductive hearing loss.
But in other cases,
it may require a bone-anchored hearing aid.
The reason a bone-anchored hearing aid works so well
for conductive hearing losses is
that it directly stimulates the inner ear hearing organ,
the cochlea, with bypassing the outer and middle ear space.
Now, if you'd like to learn more
about bone-anchored hearing aids,
feel free to check out my videos that I have on my channel,
which I will also link in the description.
At the end of the day,
it is extremely critical to precisely understand
which type of hearing loss that you have
because this will dictate which type
of treatment is right for you.
And this is another reason why I do not recommend
having your hearing tested online,
because it is literally impossible for you
to understand if you have a sensorineural hearing loss
or a conductive hearing loss.
So do yourself a favor.
If you have any difficulty hearing whatsoever,
make sure that you have your hearing tested
by a hearing care professional,
so they can accurately identify
which type of hearing loss that you have.
After all, a conductive hearing loss
that is not properly treated can lead
to more serious medical conditions down the road.
That's it for this video.
If you have any questions,
leave them in the comments section below.
If you like the video, please share it.
And if you want to see other videos just like this one,
go ahead and hit that subscribe button.
Also, feel free to check out my website, DrCliffAuD.com.
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