A 3-year-old fails an OAE screen at nursery. The child has had several recent upper respiratory infections. On examination the tympanic membranes appear dull and retracted, and tympanometry shows flat traces bilaterally.
Findings
○ Right — PTA 38 dB (Mild)✕ Left — PTA 38 dB (Mild)
Pure-tone audiogram companion. dB HL increases downward, following clinical convention. Illustrative thresholds — not recorded patient data.
— Normal ear— this case
Simulated TEOAE comparison. Educational signal model — not recorded patient data.
Diagnostic question
OAEs are absent bilaterally and tympanograms are flat. What is the most likely explanation for the absent emissions?