• Describe the abnormality.  Note – the patient was asked to swallow several times, the tympanogram did not change substantially.  What does that add to the diagnostic significance?

The 678 Hz Y and 1000 Hz Y also peak at approximately +175 daPa.

Acoustic Reflex Data

Thresholds

Reflexes are small amplitude, 0.03 or less, even at suprathreshold levels.

This patient was seen in a hospital run by a health maintenance organization.  Audiologists could write referrals for ENT evaluation without having to have the primary care physician authorize that referral.  The audiologist went that route.

• What is the significance of the reflex data; what would you indicate to the ENT as the reason(s) for referring the patient?