On pure tone audiometry of a patient with presbycusis (age-related SNHL), which audiometric configuration is MOST typical?
- A Flat sensorineural hearing loss across all frequencies
- B Low-frequency conductive loss with carhart notch at 2 kHz
- C Bilateral symmetrical high-frequency (downward sloping) sensorineural loss ✓
- D Unilateral notch at 4 kHz
Correct answer: C. Bilateral symmetrical high-frequency (downward sloping) sensorineural loss
Explanation
Presbycusis classically presents as bilateral, symmetrical, gradually progressive high-frequency sensorineural hearing loss producing a downward-sloping (high-frequency) audiogram. It is caused by degeneration of outer hair cells in the basal turn of the cochlea. The carhart notch at 2 kHz is seen in otosclerosis, and the 4 kHz notch is the hallmark of noise-induced hearing loss.
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.