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Old 03-15-2012
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Question Drummer of a heavy metal band complains of hearing loss.

A famous 35-year old male drummer of a heavy metal band complains of hearing loss. He has been on the road much of his life on tour at the demand of his fans, which are mostly females. He reports hearing the vibration from the Weber test louder in his right ear, and his Rinne test is normal. What is the most likely explanation for his hearing loss?

A. Conduction deafness caused by otosclerosis
B. Nerve deafness caused by cochlear nerve disease
C. Nerve deafness caused by prolonged exposure to noise
D. Conduction deafness caused by obstruction
E. Conduction deafness caused by exposure to heavy-metal drums
F. Nerve deafness due to herpes.
G. Conduction deafness due to herpes.
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Old 03-15-2012
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Ans ......C..........
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Originally Posted by Hitman View Post
Ans ......C..........
obstruction of the external auditory canal with a broken finger of a fan with Buerger's disease?
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Listening

If rinne is normal i.e. AC>BC so no problem with conduction. and weber lateralize to the right ear i.e Left nerve deafness.

I would go with:

C : Nerve deafness caused by prolonged exposure to noise
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Old 03-15-2012
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Ans ......C..........
i thought youve chosen obstruction
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Old 03-15-2012
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i thought youve chosen obstruction
Ear wax is more common, the more "heavy metal" the band is, the longer the hair of drummers, hence hygienic issues...
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Old 03-15-2012
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If rinne is normal i.e. AC>BC so no problem with conduction. and weber lateralize to the right ear i.e Left nerve deafness.

I would go with:

C : Nerve deafness caused by prolonged exposure to noise
if renne is normal why would you think nerve problem since he hear well?????
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Originally Posted by Kabutar111 View Post
if renne is normal why would you think nerve problem since he hear well?????
I think this way:
Rinne is the test of conduction - it compares Air Conduction vs Bone Conduction. As the question states it is normal. if the patient had problems with conduction it would appear in Rinne, i mean Bone Conduction would be increased versus air conduction -> conclusion he has no conduction problem neither in left nor in right ear.

Webber Is lateralizing to the right. there can be two reason for that.
A) Condcution problem of the right ear / gives lateralization on the same side/
B) or the nerve deafness in the left one / gives lateralization on the opposite/

While conduction problem is ruled out choice B is the best one to choose.


I think this is the right way of thinking - if not please Add comments

Drummer of a heavy metal band complains of hearing loss.-weber-rinne-table.png
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Old 01-09-2013
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thank you Beka...u made it easy & thanks for the table.
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Old 01-09-2013
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Is this a step 1 question??
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