What Is Conductive Hearing Loss and What Causes CHL?

Hearing is essential for communication, learning, and daily activities. When hearing problems occur, they can affect work, relationships, and overall quality of life.

One of the most common types of hearing problems in Indonesia is Conductive Hearing Loss (CHL). This condition affects people of all ages and is often linked to ear infections, earwax buildup, and middle ear problems.

CHL (Conductive Hearing Loss) is a condition that happens when sound cannot travel properly through the outer ear or middle ear to reach the inner ear. The inner ear and hearing nerve usually work normally, but something blocks or reduces the sound along the way.

Understanding what conductive hearing loss is, what causes it, and how it can be treated can help people seek care early and prevent long-term complications. Because of this blockage, sounds may seem quieter or muffled, as if you are listening with your ears covered.

Many people with CHL say they can hear sounds but struggle to hear clearly unless the volume is higher. One important thing to know is that conductive hearing loss is often treatable and sometimes reversible, especially when the cause is found early.

This makes early diagnosis very important.

How Common Is Conductive Hearing Loss in Indonesia?

Hearing loss is a significant health issue in Indonesia. Based on World Health Organization (WHO) data, about 4.2% of the Indonesian population experiences some form of hearing loss.

Conductive Hearing Loss is one of the most common types seen in clinical settings. CHL is frequently found in:

• Adults aged 20-60 years
• Children under three years old

Local studies show that in certain areas, such as Jatinangor, hearing loss rates can reach up to 7%, which is higher than the national average. Hospital data also shows how common CHL is.

At RSUP Prof. Dr. R.D. Kandou Hospital, for example, 43.6% of hearing loss cases diagnosed among outpatients between 2020 and 2022 were classified as Conductive Hearing Loss. Many of these patients were male.

One major contributor to CHL in Indonesia is chronic suppurative otitis media (CSOM), locally known as OMSK or “congek.” Globally, this condition affects between 65 and 330 million people, and about 60% experience significant hearing problems.

Indonesia follows a similar pattern due to environmental factors, hygiene challenges, and delayed treatment.

What Are the Most Common Causes of CHL?

Conductive Hearing Loss occurs when there is a blockage, infection, or damage in the outer or middle ear. Some of the most common causes include:

1. Chronic Suppurative Otitis Media (OMSK)

OMSK is a long-term middle ear infection that often causes:

• Continuous or repeated ear discharge
• A hole or perforation in the eardrum
• Inflammation in the middle ear

This condition is one of the leading causes of CHL in Indonesia and can affect both children and adults if not treated properly.

2. Earwax (Cerumen) Buildup

Earwax helps protect the ear, but too much wax can block the ear canal. Using cotton buds incorrectly often pushes wax deeper into the ear, making hearing worse.

3. Middle Ear Infections

Acute or repeated ear infections can cause fluid buildup behind the eardrum. This fluid blocks sound and can lead to temporary hearing loss.

4. Allergies and Nasal Congestion

Allergies, colds, or sinus problems can block the Eustachian tube, which helps regulate pressure in the middle ear. When this tube does not work properly, hearing can be affected.

5. Risk Factors in Children

Children are especially at risk for CHL. Studies show that common risk factors include:

• Frequent cotton bud use
• Long or improper use of headsets and earphones
• Congenital ear conditions such as microtia

How Is CHL Treated?

Treatment for CHL depends on the underlying cause. Common treatment options include:

• Professional ear cleaning (aural toilet)
• Topical or oral antibiotics for infections
• Decongestants or allergy treatment
• Managing chronic inflammation
• Surgical procedures if there is structural damage

The positive news is that many cases of CHL improve significantly with proper treatment. Early medical care increases the chance of restoring hearing and preventing long-term damage.

When Should You See a Doctor?

You should see a doctor if you or your child experiences:

• Ongoing hearing difficulty
• Persistent ear pain or discharge
• Repeated ear infections
• Hearing problems that affect daily communication

Early evaluation is especially important for children, as hearing problems can affect speech development and learning. At Bali International Hospital, our ENT specialists provide thorough hearing assessments, advanced diagnostic tests, and personalized treatment plans.

If you have concerns about your hearing, contact us today or book an appointment for a professional evaluation.

Frequently Asked Questions (FAQ)

What is the difference between CHL and SNHL?

Conductive hearing loss (CHL) happens when sound is blocked in the outer or middle ear, such as by earwax, fluid, or eardrum problems. Sounds are usually quieter but still clear once they are loud enough.

Sensorineural hearing loss (SNHL) involves damage to the inner ear or hearing nerve. With SNHL, sounds may be quieter and also unclear or distorted, especially in noisy environments.

CHL is often easier to treat than SNHL.

Can ear infections cause conductive hearing loss?

Yes. Ear infections are a common cause of CHL.

When fluid or pus fills the middle ear, sound cannot pass through properly. In Indonesia, chronic suppurative otitis media (OMSK or “congek”) is a leading cause of conductive hearing loss and often comes with ear discharge and moderate hearing reduction.

Is CHL permanent?

In many cases, CHL is temporary and can improve with treatment such as medication, ear cleaning, or surgery. However, if the condition is long-standing or caused by certain structural problems, it may become permanent.

Early diagnosis and treatment give the best chance for recovery.