I observed an older gentleman with high frequency hearing loss in both ears. He has two aids, one for each ear, but of course, only wears them occasionally. He has not noticed a major change in his hearing. He was taking medication for pneumonia and takes blood pressure medication regularly. He has had noise exposure due to his career.
Otoscopy revealed a large amount of wax in the right ear which caused the canal to be almost completely occluded. The left ear also showed wax but just a reasonable amount. Otherwise, the view was normal. Both tympanograms were normal.
Puretone results were as follows: Right ear- 250Hz = 25dB, 500Hz=25dB, 1000Hz=30dB, 2000Hz=35dB, 3000Hz=50dB, 4000Hz=55dB, 6000Hz=65dB, 8000Hz=65dB/ Left ear- -250Hz=20dB, 500Hz=20dB, 1000Hz=20dB, 1500Hz=35dB, 2000Hz=50dB, 3000Hz=50dB, 4000Hz=75dB, 6000Hz=95dB, and 8000Hz = no response.
The clinician explained the audiogram and gave the gentleman extra hearing protection. The clinician also suggested that the client possibly update his aids. It was also advised that having the wax removed may result in some change in hearing. Large amounts of cerumen can affect hearing through air conduction. (Roeser & Roland, 1992). The following website offers a pretty slideshow about a presbycusis study : http://www.asha.org/NR/rdonlyres/5D95975D-CA40-487A-B532-E3DA7B2305C4/0/FrisinaPresentation.pdf
Roeser, R.J. & Roland, P. (1992, November). What audiologists must know about cerumen and cerumen management. American Academy of Audiology, 1, 27-35.
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