Review Question - QID 109462

This patient's progressive hearing loss at a young age, along with a family history of surgery involving the ear is concerning for otosclerosis. On Weber testing, sound will lateralize to the affected ear.

Otosclerosis is a disorder of the middle ear that results in conductive hearing loss. On physical examination, the tympanic membranes are normal and there are no inflammatory changes of the middle ear. On Weber testing, a tuning fork is applied to the middle of the patient's forehead, with sound lateralizing to the affected ear. In Rinne testing, a tuning fork is placed on the mastoid process and once the patient no longer hears the vibration, it is then placed in front of the external auditory canal. In otosclerosis, bone conduction will be greater than air conduction of the affected ear (BC > AC).

Figure A is a healthy tympanic membrane.

Incorrect Answers:
Answer 1 & 2: Both of these physical exam findings are suggestive of sensorineural hearing loss. Otosclerosis results in conductive hearing loss.

Answer 3: Air conduction is less than bone conduction of the unaffected ear on Rinne testing describes the affected ear in otosclerosis rather than the unaffected ear.

Answer 5: Physical examination will show abnormalities in Weber and Rinne testing if there is unilateral involvement of this disorder.

Bullet Summary:
Otosclerosis is a hereditary disorder that results in conductive hearing loss, which will show BC > AC of the affected ear on Rinne testing, and sound lateralizing to the affected ear on Weber testing.