Conductive Hearing Loss

Ear wax Impaction

Can present with HL, discomfort, ear fullness, or tinnitus.

Managed by:

• Avoiding cotton buds

• Ear drops (Olive oil or Sodium Bicarb) to soften ear wax

• Ear irrigation if drops didn’t work

Eustachian Tube Dysfunction

Presents with HL, popping noise/sensation in ear, ear fullness, and discomfort, and is often associated with a precding viral URTI. Symptoms tend to get worse when the outside pressure gets too high e.g. flying, scuba diving.

Management:

• Conservative as recovery occurs once viral URTI clears

• Valsalva manoeuvre (holding and blowing nose to open up the tube)

• Grommet insertion

Tympanic membrane perforation

Can be caused by Effusion (Barotrauma), Acute trauma (head injury, cotton bud) or Barotrauma (scuba diving, explosive noise).

Other causes

• Infection i.e. Otitis media with effusion

• Cholesteatoma

• Otosclerosis - Remodelling and stiffening of ossicles in the middle ear (mainly affects base of the stapes), therefore preventing sound from being transmitted as effectively

  • Patients often present with a lower pitch HL that improves with background noise, and tinnitus