Clinical Cases
Worked clinical cases. Read the vignette, study the audiogram and reflex grid, commit to an answer, then check your reasoning against the explanation.
Progressive hearing loss in a young adult
A 32-year-old reports two years of gradually worsening hearing in the right ear, worse in quiet, with a family…
Noise-exposed worker with symmetric loss
A 58-year-old retired factory worker has long-standing symmetric hearing difficulty. Audiometry shows a modera…
Asymmetric hearing loss and tinnitus
A 47-year-old describes one year of right-sided tinnitus and a sense that the phone is harder to use on the ri…
Sudden facial weakness
A 40-year-old develops acute left facial weakness over a day, with the left brow and lower face involved. Hear…
Diplopia, imbalance and subtle reflex findings
A 36-year-old presents with intermittent diplopia and imbalance. Pure-tone hearing is normal bilaterally. Tymp…
A child who passed newborn screening now struggling in noise
A 6-year-old has marked difficulty understanding speech in noise despite only a mild audiometric loss. Otoacou…
Hearing loss after a head injury
A 28-year-old reports right-sided hearing loss since a road traffic accident six months ago. Otoscopy is norma…
A puzzling combination on the same side
A 61-year-old has a right-sided mixed hearing loss — a sensorineural component with an additional air–bone gap…
A child who failed a school hearing screen
A 6-year-old failed a school hearing screen and has had several recent colds. The parents report the televisio…
An adult claiming total deafness in one ear
A 34-year-old reports complete loss of hearing in the right ear following a workplace dispute, with a compensa…
Abnormal decay that recovers after rest
A 41-year-old reports drooping eyelids that worsen through the day and occasional double vision. Pure-tone hea…
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