Hearing Assessment

Patient Information

• Name: Arthur Pendelton
• DOB: 14/05/1952
• Gender: Male
• Date of assessment: 24/10/2023

Reason for Referral

• Referred by GP (Dr S. Jenkins) for evaluation of progressive bilateral hearing loss and concomitant vestibular symptoms (balance instability and episodic vertigo).

History

• Gradual onset bilateral hypoacusis over 3 yrs, worse in background noise. Spouse notes increased TV volume. Reports intermittent high-pitched non-pulsatile tinnitus bilaterally. Also notes mild unsteadiness on uneven ground (currently under vestibular physiotherapy). Denies otalgia, otorrhoea, or aural fullness.
• PMH: HTN, T2DM, OA (bilateral knees). Prior surgery: R total knee replacement (2019). No Hx of recurrent otitis media or head trauma.
• Perindopril 5 mg PO OD, metformin 1,000 mg PO BD, glucosamine sulfate 1,500 mg PO OD. No history of ototoxic Rx.
• Retired boilermaker; 35-year history of significant occupational noise exposure with inconsistent PPE use. Lives with wife in a single-storey house. Ex-smoker (ceased 2005), social EtOH.
• Penicillin (rash).

Examination

• Bilateral external auditory canals clear, nil cerumen impaction. Tympanic membranes intact, pearly grey, normal landmarks andcone of light visible bilaterally.
• Bilateral Type A tympanograms. Ear canal volume: R 1.2 mL, L 1.3 mL. Static compliance: R 0.7 mmho, L 0.8 mmho. Middle ear pressure: 0 daPa bilaterally.
• Bilateral symmetrical sensorineural hearing loss (SNHL). Normal thresholds 250–1,000 Hz (15–20 dB HL), sloping to moderate-to-severe loss at 2,000–8,000 Hz, with a classic noise-induced notch at 4,000 Hz (R 60 dB HL, L 65 dB HL). No air-bone gap.
• Word Recognition Score (WRS) in quiet: R 84 % at 65 dB HL, L 80 % at 65 dB HL. Rollover absent.

Assessment

• 71 yo male with normal middle ear function and bilateral symmetrical high-frequency SNHL, consistent with presbycusis compounded by prior occupational noise exposure.
• Bilateral noise-induced and age-related sensorineural hearing loss (presbycusis).

Plan

• Discussed audiometric results and communication strategies (e.g., reducing background noise, facing speakers). Recommended binaural behind-the-ear (BTE) hearing aids; patient keen to proceed under the Hearing Services Program (HSP). Continue concurrent vestibular rehabilitation with physiotherapy for balance deficits.
• Booked for hearing aid fitting and real-ear measurements in 2 weeks. Copy of report sent to referring GP.

Clinician Information

• Liam Vance, Physiotherapist & Vestibular/Audiology Clinician
• L. Vance (Electronically signed)
• 24/10/2023 14:15 AWST