Question: An 87 year old male is evaluated for hearing impairment. Audiogram shows bilateral severe to profound hearing loss with word recognition scores of 30% in each ear at a presentation level of 100 dB. He uses hearing aids in each ear. Ear examination demonstrates normal shaped pinnae and normal appearing TMs. Review of an old head CT from a prior fall reveals sclerotic mastoid cavities. He is fully ambulatory and has good manual dexterity. His medications include daily aspirin, donepezil, and two anti-hypertensive medications. CNC and AzBio word and sentence test batteries are administered and he is deemed a cochlear implant candidate. MRI shows T2 signal in both cochleas. What characteristic of this patient has the highest likelihood of negatively affecting his cochlear implant performance?

a) History of hypertension
b) Use of donepezil
c) Age
d) Sclerotic mastoids
e) Poor word recognition

[Answer will be posted with next week's new question]

Answer to last week's question, "Deep Breaths" (April 22, 2018)

Concentric palatal collapse.