History:Yourpatientisa26-year-oldfemalewithacomplaintofdiminishedhearingforseveralyearsthatseemstobegettingworse.Hermotherhastoldyouthatthepatientexperiencedearinfectionsasasmallchild,butthepatientherselfhasnomemory of this. She has increased difficulty hearing while chewing but seems, to hersurprise, to understand speechbetter in a noisybackground than in quietplaces.Thepatienthastwooldersisterswithhearinglossesthatbeganinearlyadulthood.One wears hearing aids successfully and the other was helped by surgery, the natureofwhichthepatientdoesnotknow.
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