A 49-year-old is referred with a low-frequency air–bone gap initially attributed to otosclerosis. Stapedial reflexes are present, and the patient also reports vertigo on hearing loud sounds. The affected-ear cVEMP is augmented and elicited at a low threshold.

Affected earContralateral ear

Despite an audiometric air–bone gap, the affected-ear cVEMP is augmented at a low threshold — a third-window signature, not a middle-ear one.

An air–bone gap with PRESENT stapedial reflexes and an augmented, low-threshold cVEMP is best explained by:

Select an option to continue.

← All clinical cases

Affected earContralateral ear

Despite an audiometric air–bone gap, the affected-ear cVEMP is augmented at a low threshold — a third-window signature, not a middle-ear one.

An air–bone gap with PRESENT stapedial reflexes and an augmented, low-threshold cVEMP is best explained by:

Select an option to continue.

← All clinical cases

An air–bone gap that hides a third window

An air–bone gap with PRESENT stapedial reflexes and an augmented, low-threshold cVEMP is best explained by:

An air–bone gap that hides a third window

An air–bone gap with PRESENT stapedial reflexes and an augmented, low-threshold cVEMP is best explained by: