Clinical Case · foundation

Progressive hearing loss in a young adult

History

A 32-year-old reports two years of gradually worsening hearing in the right ear, worse in quiet, with a family history of hearing loss. Otoscopy is normal. Tympanometry shows a shallow (type As) trace 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
Absent
Absent
Probe Left
Present
Present

Which interpretation best fits the reflex pattern?