Hearing Loss Types — Conductive vs Sensorineural

A 38-year-old woman with a 2-year history of progressive hearing loss undergoes audiometry showing air-bone gap of 35 dB and normal bone conduction thresholds. Which feature most reliably distinguishes this conductive hearing loss from sensorineural hearing loss?

A 52-year-old man presents with progressive bilateral hearing loss over 6 months. Otoscopy is normal. Weber test shows lateralization to the right ear, and Rinne test shows bone conduction better than air conduction bilaterally. Pure tone audiometry confirms sensorineural hearing loss. He denies tinnitus, vertigo, or otalgia. What is the most appropriate next step in management?

A 35-year-old woman presents with progressive hearing loss over 6 months. Otoscopy shows a whitish, pearly lesion in the anterosuperior quadrant of the tympanic membrane. Weber test shows lateralization to the affected ear, and Rinne test shows bone conduction better than air conduction on the affected side. What is the most common cause of conductive hearing loss in this clinical presentation?

A 72-year-old man with a 10-year history of gradually progressive bilateral hearing loss presents to the audiology clinic. Pure tone audiometry shows a bilateral high-frequency sensorineural hearing loss with an air-bone gap of <10 dB. Speech discrimination is reduced. What is the most common cause of sensorineural hearing loss in this age group?

All of the following clinical findings are characteristic of conductive hearing loss EXCEPT: