History	Physical findings	Audiogram	Suggested cause of sensorineural hearing loss
Gradual hearing loss, noise exposure, tobacco use	Elderly patients with normal tympanic membrane	Bilateral, symmetric high-frequency loss	Presbycusis
Gradual hearing loss, tinnitus, noise exposure	Normal tympanic membrane	Bilateral, symmetric loss centered at 4,000 Hz	Noise-induced traumatic loss
Rapidly progressive hearing loss, possibly fluctuating, bilateral loss	Normal tympanic membrane, with possible vertigo or disequilibrium	Any abnormal configuration with poor speech discrimination	Autoimmune hearing loss
Sudden unilateral hearing loss, tinnitus, vertigo, head trauma, straining	Normal tympanic membrane; vertigo and nystagmus, with positive pneumatic pressure	Any unilateral abnormal configuration	Perilymph fistula
Sudden, fluctuating, unilateral hearing loss, tinnitus, episodic vertigo	Normal tympanic membrane	Unilateral low-frequency loss	Meniere's disese
Gradual unilateral hearing loss, tinnitus	Normal tympanic membrane, possible facial nerve weakness and unsteadiness	Any unilateral abnormal configuration	Acoustic neuroma