Case History / Examination
P.M., a 78 years old woman, was admitted to our audiologic service for
bilateral ear discharge, ear pruritus and pain and progressive hearing
loss, developed 5 years before, but rapidly worsened in the last 12
months. In the last 6 months the patient had been using bone conduction
hearing aids spectacles with very limited benefit. The otomicroscopy and
the otoendoscopy showed an easy to blood, totally stenotic external
auditory canal (EAC) bilaterally. Tympanic membrane was not visible,
bilaterally. Tonal audiometry revealed a severe to profound mixed
bilateral hearing loss, with an air conduction pure tone average
500-1000-2000-4000Hz (PTA) of 96,25dB on the left side and 103,75dB on
the right side and a bone conduction PTA of 50dB on the left side and
45dB on the right side (Fig. 1). The free field unaided audiometry
showed a PTA of 100dB and a PTA of 70 dB with the bone conduction
hearing aids spectacles (Fig. 2). The open set disyllabic words
recognition score with bone conduction hearing aids spectacles was 30%
in silence and 15% with background noise (SNR +10); further, the
patient showed no open set speech recognition abilities unaided.