A 70-year-old patient with pure-tone audiometry showing bilateral high-frequency hearing loss with preserved speech discrimination represents which type of hearing loss?

• A Sensorineural hearing loss (cochlear/hair cell damage) ✓
• B Conductive hearing loss
• C Retrocochlear (auditory nerve) lesion
• D Central auditory processing disorder

Explanation

Age-related high-frequency sensorineural hearing loss (presbycusis) results from progressive loss of basal-turn cochlear hair cells, which are responsible for encoding high-frequency sounds. Hair cells near the cochlear apex detect low frequencies and are affected later. Conductive hearing loss shows an air-bone gap and flat audiogram. Retrocochlear lesions (acoustic neuroma) typically cause disproportionate speech discrimination loss. Cochlear (sensorineural) loss shows no air-bone gap on audiometry.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.