Trainee

A 38-year-old with ear fullness and a flying history

A 38-year-old frequent flyer reports recurring ear fullness and a sense that the ear 'won't clear', worse on descent. Hearing is only mildly affected. Otoscopy shows a retracted but intact drum.

Investigations

Audiogram

0204060801001202505001k2k4k8kFrequency (Hz)Hearing level (dB HL)[[[[[[ air conduction[ bone conduction

Tympanogram

-400-300-200-10001002000.00.51.01.52.02.53.0Ear-canal pressure (daPa)Admittance (mmho)

Peak shifted markedly negative with otherwise normal amplitude. Mild low-frequency air-bone gap. Reflexes present.

Which is the best interpretation?