Clinical Case · trainee

Hearing loss after a head injury

History

A 28-year-old reports right-sided hearing loss since a road traffic accident six months ago. Otoscopy is normal. Audiometry shows a large right conductive loss with a wide air–bone gap. Tympanometry on the right is unusually deep (type Ad).

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

The deep tympanogram and absent right probe-ear reflexes together suggest: