Dave Brooster Research Paper

Dave Brooster, a 19-year-old male, came into my practice today after being referred by the military hospital for further evaluation. He was referred by a military physician to get a comprehensive evaluation of his hearing after failing a hearing screening on his base. Dave reports having a ringing in his right ear and but is still hearing normally. In his left ear, Dave reports not hearing as well as before where he isn’t able to catch some words in a conversation as well as he could before. His Drill Sargent reports that they have been training with firearms over the past week before Dave reported any problem with his hearing. Dave mentioned that the hearing protection that was provided to them did not fit in his ears very well and would frequently fall out during practice. Since then, there has been no improvement in his hearing accompanied by the tinnitus and no change in his re-screening. Dave is worried that his military career will be short lived and his life after leaving the
The ear canal volume (ECV) was at 1.6cc bilaterally which is normal for Dave’s age.
The Acoustic Reflex Threshold (ART) were tested at 500 Hz, 1000Hz, and 2000Hz. There was no indication of inner ear problems at these frequencies. Left Ear Right Ear
@500 Hz 85 dBHL 80 dBHL
@ 1000 Hz 85 dBHL 85 dBHL
@ 2000 Hz 85 dBHL 90 dBHL

Recommendations
Dave’s problems are consistent with a noise induced hearing loss (NIHL). When looking at the results that were obtained by an otoscopic exam, pure tone audiometry, speech audiometry, and immittance audiometry, it is evident that there is no medical treatment will improve his hearing. I recommend staying away from loud noises and using hearing protection that fits correctly in his ears. Due to the rest of his hearing being in the normal range except at 4000 Hz, there is no need for hearing aids at this time. Yearly check-up will be made to watch his