Patient History

Age:                74

Gender:          F

The patient complains of hearing loss in the left ear only, and episodic dizziness in the past month, which is not present today.  She describes the dizziness as a lightheadedness.  She has occasional sensation of her ear “feeling different” and she thinks there may be an association between that sensation and the dizziness. Hearing does not change with the dizziness.  She reports that last year she had episodic dizziness that she related to her medications.

She indicates the left ear has always been the poorer ear but says that now there is a “dramatic change”.  She says she only hears the bass of music now.  She considers her right ear “quite adequate.”

She has “sinus problems” that are not symptomatic on the day of evaluation.  She has longstanding ringing tinnitus in the left ear.  She is not reporting otalgia.

Otoscopy

Unremarkable.  ENT physician evaluation also indicates that the appearance of the ears is within normal limits.

• Basing your opinion ONLY on the patient reports, what are your thoughts on her dizziness and the possible causes for it?