Clinical Case · clinician

A puzzling combination on the same side

History

A 61-year-old has a right-sided mixed hearing loss — a sensorineural component with an additional air–bone gap. Tympanometry on the right is shallow. Reflexes are absent with the probe in the right ear and present with the probe in the left.

Findings

Pure-tone audiogram

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

Acoustic reflex grid

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

Why are the right probe-ear reflexes absent here?