Ambulatory Care Topics: Hearing Loss. Gustavo R. Heudebert, MD Division of General Internal Medicine. Road Map. Physiology of hearing Topography of hearing loss Differential Diagnosis Clues from history / physical examination Evaluation. Case.
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Gustavo R. Heudebert, MD
Division of General Internal Medicine
34 yo male comes to the walk-in clinic with a 36 hour
history of hearing loss. Onset has been sudden, the the
hearing loss is associated with mild bilateral ear pain
but no drainage. There is no dizziness or tinnitus.
Patient is healthy and takes no medications. Family
history is non contributory. There is no exposure to
alcohol, tobacco, or illicit drugs. He works at a hospital.
Physical examination is unrevealing except for the
AC > BC
If BC > AC
Conductive disorder on affected ear
Lateralizes to “good ear”
SNHL on bad ear
Lateralizes to “bad ear”
Conductive disorder of that earInterpretation
SOM / AOM
HemorrhageConductive Hearing Loss
CVASensorineural Hearing Loss