Sudden sensorineural hearing loss — CCFP MCQ

Instant feedback + full explanation. One question, done properly.

ModerateENT, OphthalmologySudden sensorineural hearing lossCCFP

A 52-year-old man wakes with sudden unilateral hearing loss and tinnitus. Otoscopy is normal, Weber test lateralises to the unaffected ear, and Rinne is positive bilaterally. He has no vertigo or focal neurology. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Urgent audiometry with ENT assessment

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

This patient has sudden sensorineural hearing loss (SSNHL), a medical emergency. Canadian clinical practice mandates urgent referral for both audiometry and ENT assessment. Audiometry is the gold standard investigation: it definitively confirms sensorineural pathology by measuring air and bone conduction thresholds and quantifies the degree of loss. This information is essential for initiating treatment (usually corticosteroids) within the critical window and ruling out retrocochlear causes (such as acoustic neuroma) via MRI if clinically indicated. Option A (delayed tympanometry) misses the urgency and uses an inappropriate test (tympanometry assesses middle ear, not inner ear). Options C, D, and E are pathologically irrelevant. Correct answer: B.

Reference: College of Family Physicians of Canada. Approach to hearing loss. Canadian Family Physician. 2020;66(11):803–810. https://www.cfp.ca/content/66/11/803