What does conductive hearing loss sound like?

Conductive hearing loss happens when sound is blocked or reduced somewhere in the outer or middle ear before it reaches the inner ear. Because the inner ear itself may be working normally, the classic experience is that sounds seem quieter or muffled rather than harsh or distorted. Many people describe it as feeling like they have earplugs in, cotton wool in the ear, or are listening from underwater.

How do people describe the sound?

Everyone experiences it slightly differently, but common descriptions include:

• Speech and everyday sounds seem softer, as though someone turned the volume down.
• Your own voice sounds louder, boomy or echoey inside your head.
• Sounds are muffled rather than crackly or scrambled.
• Chewing, swallowing or your own footsteps can seem unusually loud.
• A blocked or full feeling in the ear, sometimes with reduced hearing on one side.

This differs from sensorineural hearing loss, where sounds are often loud enough but hard to make out clearly, especially in background noise.

What causes conductive hearing loss?

Conductive hearing loss has many possible causes, and several are temporary. Common ones include:

• Earwax build-up blocking the ear canal.
• Middle-ear infection or fluid behind the eardrum, common after a cold.
• A perforated (torn) eardrum.
• Problems with the small middle-ear bones or the Eustachian tube.
• A foreign object in the ear canal.

Because some of these can be addressed, conductive hearing loss is sometimes reversible, unlike many forms of permanent hearing loss. That is one reason it is worth having checked rather than assuming nothing can be done.

When should you get it checked?

It is sensible to see a GP or audiologist if hearing in one or both ears becomes muffled and does not clear within a week or two, or if you also notice ear pain, discharge, dizziness or a sudden change. Sudden or one-sided hearing loss should be checked promptly, as early assessment can matter.

A hearing assessment can tell you whether a loss is conductive, sensorineural or a mix of both. Audiologists use tests such as an audiogram, along with tympanometry to check how the eardrum and middle ear are working. This helps identify the cause and the most appropriate next step, which might be as simple as clearing earwax or treating an infection through your GP.

Can you have more than one type at once?

Yes. Some people have a mixed hearing loss, where a conductive problem in the outer or middle ear sits alongside sensorineural change in the inner ear. In that situation, sounds may seem both quieter and less clear, blending the muffled quality of conductive loss with the difficulty understanding speech that is typical of sensorineural loss. This is one reason a single symptom is rarely enough to tell the types apart.

During an assessment, an audiologist compares how you hear sound through the air with how you hear it through gentle bone conduction. The gap between these two measurements helps show whether the issue is conductive, sensorineural or a mix of both. Identifying the pattern matters because it guides the most suitable next step, whether that is clearing earwax, a GP review for an infection, or discussing hearing devices. It also gives a clear baseline, so any future change can be compared against it.

What can be done about it?

Management depends entirely on the cause, so there is no single answer. Removing earwax, treating an infection, or allowing middle-ear fluid to settle can improve hearing in many cases. Where a conductive loss is longer lasting, options may include medical or surgical care through an ear specialist, or hearing aids to lift the volume of sound.

Hearing Help is an independent clinic at Newport Marketplace on the Redcliffe Peninsula, and you do not need a referral to book a hearing assessment. If your hearing feels muffled or blocked, a check is a straightforward way to find out what is going on and what, if anything, may help.