Pure-tone audiometry of a 30-year-old shows an average air-conduction threshold of 60 dB HL at 500, 1000 and 2000 Hz, but the speech recognition threshold measures 15 dB HL. This large discrepancy between SRT and pure-tone average most strongly suggests:

• A Severe cochlear hearing loss
• B Auditory neuropathy spectrum disorder
• C Advanced otosclerosis
• D Non-organic (functional) hearing loss ✓

Explanation

The SRT normally agrees with the pure-tone average of 500, 1000 and 2000 Hz within about 6 to 10 dB because both depend on the same low-frequency sensitivity. An SRT far better than the PTA is a classic indicator of exaggerated hearing loss, since feigning consistent thresholds across frequencies is difficult. Cochlear and conductive losses keep the two values concordant.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.