A 58-year-old reports several years of gradual bilateral hearing difficulty, worse in noise. Otoscopy is normal and tympanometry shows normal middle-ear function. Pure-tone audiometry shows a bilateral high-frequency sensorineural loss.
Findings
○ Right — PTA 37 dB (Mild)✕ Left — PTA 42 dB (Moderate)
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
TEOAEs are absent bilaterally. Given the normal tympanograms, what does the absent emission indicate?