<prompt> A 65-year-old person with BL SN hearing loss with proportionate speech discrimination is suffering from:Noise induced hearing lossPresbycusisOtotoxic drugAcoustic neuroma  <response>: b PresbycusisRef. Cummings, 6th ed., 2331Presbycusis, Noise induced hearing loss and ototoxic drugs all can lead to BL SN hearing loss mainly high frequency with proportionate decrease in speech discrimination as all affect the cochlea. The speech discriminationword recognition scores are far worse than would be predicted from that ears pure tone findings in retrocochlear deafness acoustic neuroma. Moreover acoustic neuroma is UL.In the above question no history of noise exposure or ototoxic drug intake has been mentioned, ruling out acoustic trauma or ototoxicity. The age here is also suggesting Presbycusis. 