Question of the Week # 325

325 )  A 87 year old Caucasian man is evaluated in your office for progressive hearing loss. He reports defective hearing on both sides that started more than a year ago and has gradually worsened. The problem is particularly worse when he is in a crowded or noisy environment. He also reports frequent occurrence of roaring sounds and sounds similar to “ringing bells” in his ears. On otoscopic examination, he has mild cerumen impaction in bilateral ears. The Tympanic membranes are intact. Which of the following is the most characteristic feature seen with this condition?

A) Inability to hear “Vowel” sounds in the speech

B) Audiogram showing bilateral high-frequency sensory-neural hearing loss

C) Weber Test showing lateralization towards Right ear

D) A negative Rinne test

E) Otosclerosis

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