• Patient who had normal hearing up until 3 years ago who has had potential barotrauma (snorkeling-related ear pain) and loud noises who has loss of high-frequency noises, most consistent with noise-related hearing loss
• Key idea: Elderly patients who have had chronic exposure to noise will first lose high-frequency sounds (bilateral, symmetric sensorineural hearing loss), with young patients with increased exposure to loud noises being able to lose the high-frequency sounds due to destruction of hair cells at the cochlear base

https://step-prep.org/tutoring/

Audiogram typically compares AC vs BC to differentiate conductive vs. SN. Not R & L like the one in the question. I guess they just were trying to show it was bilateral?

Aside from that, loss of high frequency sounds only is similar to presbycusis (SN hearing loss). Pathophy is progressive damage to hair cells (high freq.) due to chronic exposure to loud sounds. Noice-induced hearing loss can cause a similar SN hearing loss in younger people.

However, barotrauma would cause a conductive hearing loss.