Clinical Case · foundation

Noise-exposed worker with symmetric loss

History

A 58-year-old retired factory worker has long-standing symmetric hearing difficulty. Audiometry shows a moderate sloping sensorineural loss with no air–bone gap. Tympanometry is type A bilaterally.

Findings

Pure-tone audiogram

0204060801002505001k2k4k8kFrequency (Hz)Hearing level (dB HL)
○ Right ear✕ Left ear

Acoustic reflex grid

Stim. Right
Stim. Left
Probe Right
Present
Present
Probe Left
Present
Present

The reflex thresholds are present at near-normal dB HL levels. What does this indicate?