A 65-year-old person with B/L SN hearing loss with proportionate speech discrimination is suffering from:
Noise induced hearing loss
Presbycusis
Ototoxic drug
Acoustic neuroma
(b) Presbycusis(Ref. Cummings, 6th ed., 2331)Presbycusis, Noise induced hearing loss and ototoxic drugs all can lead to B/L SN hearing loss (mainly high frequency) with proportionate decrease in speech discrimination as all affect the cochlea. The speech discrimination/word recognition scores are far worse than would be predicted from that ear's pure tone findings in retrocochlear deafness (acoustic neuroma). Moreover acoustic neuroma is U/L.In the above question no history of noise exposure or ototoxic drug intake has been mentioned, ruling out acoustic trauma or ototoxicity. The age here is also suggesting Presbycusis.
Ear