A 34-Year-Old Woman Comes to the Office Due to Difficulty

A 34-year-old woman comes to the office due to difficulty hearing, especially in the left ear.  The hearing loss has worsened over the past year, and she is now having trouble hearing people at work; however, when the environment is noisy, she can understand speech better than when she is in a quiet room.  The patient also hears ringing in the left ear.  She has no dizziness, vertigo, or ear pain.  She has had no significant noise exposure.  The patient has no other medical conditions and takes no medications.  Her mother had surgery for hearing loss when she was in her 40s.  On examination, the tympanic membranes are clear with a good light reflex, good landmarks, and no middle ear effusion.  There is a slight reddish hue behind the left tympanic membrane.  Which of the following is the most likely mechanism of this patient's condition?

A) Bony overgrowth of the ossicles
B) Degeneration of neuronal cell bodies
C) Increased fluid in the cochlea
D) Lamellated basement membrane
E) Neoplastic growth involving CN VIII

Correct Answer:

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