Clinical Case · clinician

An adult claiming total deafness in one ear

History

A 34-year-old reports complete loss of hearing in the right ear following a workplace dispute, with a compensation claim pending. Pure-tone audiometry shows no responses at any frequency in the right ear and normal thresholds on the left. Otoscopy and tympanometry are normal bilaterally. Otoacoustic emissions are robustly present on the right.

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

Reflexes are present at normal levels in all four conditions. How should this be interpreted?