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.