A 70-year-old man has bilateral symmetric sloping high-frequency sensorineural hearing loss on audiometry, worse at 4000-8000 Hz, with normal low frequencies. He reports difficulty understanding speech in noise. There is no history of noise exposure or ototoxic drug use. What type of hearing loss does this pattern represent?

• A Noise-induced hearing loss
• B Autoimmune inner ear disease
• C Presbycusis (age-related hearing loss) ✓
• D Sudden sensorineural hearing loss

Explanation

Presbycusis is bilateral, symmetric, progressive, age-related sensorineural hearing loss due to cochlear degeneration, predominantly affecting high frequencies first. The audiogram shows a gradually sloping loss at 2000-8000 Hz. The difficulty understanding speech in background noise (cocktail party problem) is characteristic, related to loss of temporal resolution and central auditory processing changes. The most common pathological type is sensory (hair cell loss at the basal cochlea) or neural (cochlear neuron degeneration). Bilateral hearing aids are the mainstay of treatment.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.