Overview Snapshot A 30-year-old woman presents to her primary care physician due to worsening hearing loss of the right ear. This has never happened before and she denies any trauma to the ear. She has also noticed ear ringing of the right ear. Medical history is unremarkable. Family history is significant for her father undergoing surgery of the ear due to hearing loss. On physical exam, a conductive hearing loss is noted on Weber and Rinne testing. (Otosclerosis) Introduction Hearing loss basic principles unilateral hearing loss can result from lesions affecting the login to view 5 more bullets bilateral hearing loss suggests login to view 2 more bullets hearing loss is generally divided into conductive hearing loss login to view 3 more bullets sensorineural hearing loss login to view 3 more bullets Conductive hearing loss etiologies include otitis externa squamous cell carcinoma osteoma cerumen otitis media cholesteatomoa otosclerosis tympanic membrane perforation Sensorineural hearing loss etiologies include hereditary hearing loss presbycusis login to view 1 more bullet ototoxic drugs Meniere disease barotrauma acoustic neuroma multiple sclerosis Physical exam maneuver Rinne test compares air conduction to bone conduction login to view 4 more bullets normal findings are login to view 1 more bullet pathology login to view 6 more bullets Weber test the vibrating tuning fork is placed in the middle of the patient's forehead login to view 1 more bullet normal findings login to view 1 more bullet pathology login to view 5 more bullets