Conductive Hearing Loss

Aka: Conductive Hearing Loss

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II. Epidemiology

  1. Age of onset under age 40 years
  2. Most common cause of Hearing Loss

III. Causes

  1. Infection (and sequelae)
    1. Middle ear effusion
      1. Otitis Media with Effusion (20-30 db Hearing Loss)
      2. Eustachian Tube Dysfunction
    2. Otitis Externa
    3. Mastoiditis
  2. Obstruction
    1. Cerumen Impaction (complete ear canal Occlusion)
    2. Ear Canal Foreign Body
    3. External canal oxostoses (Surfer's Ear)
  3. Sclerosis
    1. Otosclerosis
    2. Severe Myringosclerosis (Tympanosclerosis)
  4. Neoplasms and Masses
    1. Cholesteatoma
    2. Glomus tumor
    3. Bony growths of ear canal (exostosis or osteoma)
  5. Trauma
    1. Ossicular Chain Disruption
    2. Tympanic Membrane Perforation
      1. Head Trauma
      2. Barotrauma (Rapid descent in air or water, straining)

IV. Symptoms

  1. Minor impaired word understanding
    1. See Hearing Impairment Severity Scale
  2. Hearing not impaired in a noisy environment
  3. Patient does not raise their voice

V. Signs

  1. Otoscopy
    1. Abnormal Ear Canal or Tympanic Membrane
  2. Weber Test (Tuning Fork at Midline) Abnormal
    1. Sound radiates to the ear with conductive loss
    2. Conductive loss shuts out noisy environment
  3. Rinne Test (Tuning fork on Mastoid) Abnormal
    1. Bone Conduction is better than Air Conduction
  4. Hum Test
    1. Conductive Hearing Loss will localize to the affected ear
    2. Contrast with Sensorineural Hearing Loss which will localize to the unaffected ear

VI. Diagnostics

  1. Tympanogram
  2. Audiogram

VII. Management

  1. Treat Suppurative Otitis Media if present
  2. See Eustachian Tube Dysfunction
  3. Otolaryngology for suspected structural disorders

VIII. References

  1. Cunningham (2017) N Engl J Med 377(25): 2465-73 [PubMed]
  2. Edmiston (2013) BMJ 346: f2495 +PMID:23618723 [PubMed]
  3. Uy (2013) Ann Intern Med 158(7): ITC4-1 +PMID:23546583 [PubMed]
  4. Michels (2019) Am Fam Physician 100(2): 98-108 [PubMed]

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Related Studies

Ontology: Conductive hearing loss (C0018777)

Definition (NCI) Hearing loss caused by a problem in the outer ear or middle ear. Conductive losses usually affect all frequencies to the same degree. These losses are not usually severe.
Definition (CSP) involves lesions of the external and middle ear resulting in malconduction of airborne sound.
Definition (MSH) Hearing loss due to interference with the mechanical reception or amplification of sound to the COCHLEA. The interference is in the outer or middle ear involving the EAR CANAL; TYMPANIC MEMBRANE; or EAR OSSICLES.
Concepts Disease or Syndrome (T047)
MSH D006314
ICD9 389.00, 389.0
ICD10 H90.2
SnomedCT 155255001, 194420001, 194412003, 44057004
English Hearing Loss, Conductive, Conductive hearing loss, Conductive hearing loss NOS, Conductive hearing loss, unsp., Conductive hearing loss, unspecified, Unspecified conductive hearing loss, conductive hearing loss, conductive hearing loss (diagnosis), Conduct hearing loss NOS, Conductive deafness NOS, Hearing Loss, Conductive [Disease/Finding], Deafness;conductive, conductive loss hearing, Deafness, conductive, Hearing loss, conductive, Conductive hearing loss NOS (disorder), Unspecified conductive hearing loss (disorder), Conductive Deafness, CD - Conductive deafness, CHL - Conductive hearing loss, Conductive deafness, hearing; loss, conductive disorder, loss; hearing, conductive disorder, Conductive deafness, NOS, Conductive hearing loss, NOS, Conductive Hearing Loss, conductive deafness, Conductive hearing loss (finding), Conductive hearing loss NOS (finding), Unspecified conductive hearing loss (finding), Conductive hearing loss (disorder)
Italian Sordità di conduzione, Sordità di conduzione, non specificata, Ipoacusia di trasmissione
Dutch geleidingsgehoorverlies, geleidingsgehoorverlies, niet-gespecificeerd, gehoor; verlies, door geleidingsstoornis, verlies; gehoor, door geleidingsstoornis, Gehoorverlies door geleidingsstoornis, niet gespecificeerd, geleidingsdoofheid, Geleidingsslechthorendheid, Slechthorendheid, geleidings-, Geleidingsdoofheid
German konduktiver Gehoerverlust, unspezifisch, konduktiver Gehoerverlust, Hoerverlust durch Schalleitungstoerung, nicht naeher bezeichnet, Schallleitungsschwerhoerigkeit, Schwerhörigkeit, Schalleitungs-
Portuguese Défice auditivo de condução NE, Défice auditivo de condução, Perda auditiva de transmissão, Perda Auditiva Condutiva
Spanish Pérdida de audición de transmisión, Pérdida de audición de transmisión no especificada, pérdida auditiva de conducción (hallazgo), hipoacusia de conducción, SAI (hallazgo), pérdida de audición de conducción no especificada (hallazgo), pérdida de la audición conductiva, sordera conductiva, pérdida de la audición conductiva (trastorno), pérdida auditiva de conducción, pérdida auditiva de conducción (trastorno), hipoacusia conductiva, pérdida de audición de conducción no especificada (trastorno), hipoacusia de conducción, SAI (trastorno), pérdida de audición de conducción no especificada, hipoacusia de conducción, SAI, Hipoacusia de Conducción, Sordera de transmisión, Pérdida Auditiva Conductiva
Japanese 詳細不明の伝音性難聴, ﾃﾞﾝｵﾝﾅﾝﾁｮｳ, ｼｮｳｻｲﾌﾒｲﾉﾃﾞﾝｵﾝｾｲﾅﾝﾁｮｳ, 伝音性聴力損失, 聴力損失-伝音性, 伝音難聴, 伝音性難聴, 難聴-伝音, 難聴-伝音性
Swedish Ledningshörselnedsättning
French Perte d'audition conductive, non précisée, Perte d'audition conductive, Surdité de transmission, Surdité de conduction, Perte d'audition de transmission, Déficience auditive de transmission, Perte auditive de transmission
Finnish Johtumistyyppinen huonokuuloisuus
Russian GLUKHOTA PROVODNIKOVAIA, GLUKHOTA KONDUKTIVNAIA, SLUKHA POTERIA KONDUKTIVNAIA, ГЛУХОТА КОНДУКТИВНАЯ, ГЛУХОТА ПРОВОДНИКОВАЯ, СЛУХА ПОТЕРЯ КОНДУКТИВНАЯ
Czech Převodní ztráta sluchu, Převodní nedoslýchavost, Převodní ztráta sluchu, blíže neurčená, převodní nedoslýchavost, nedoslýchavost převodní
Korean 상세불명의 전음성 난청
Croatian SLUH, GUBITAK, KONDUKTIVNI
Polish Utrata przewodzenia bodźców słuchowych, Utrata przewodności słuchu
Hungarian vezetéses hallásvesztés, nem meghatározott, vezetéses süketség, Vezetéses hallásvesztés
Norwegian Konduktivt hørselstap, Hørselstap, konduktivt
Derived from the NIH UMLS (Unified Medical Language System)

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