One week after taking a 4-hour flight home from a hunting trip, an 18-year-old man presents with hearing loss and tinnitus. on examination, his external auditory canal and tympanic membranes appear normal. results of a rinne test are normal bilaterally, and a weber test is localized to the right side. an audiogram demonstrates a moderate high-frequency sensorineural hearing loss in the left ear. what is the most likely cause of the hearing change?

The most likely cause of the hearing change is a long exposure to high-frequency noise during a 4-hour flight.

Explanation:

The most common high-frequency sensorineural hearing loss is normally caused by noise exposure or aging, and often both. In this condition loud noises like a plane taking off or explosion damage the hair cells at the base of the cochlea.

The man experiencing tinnitus and hearing loss after the four-hour flight and as per the audiogram demonstration, the cause of the hearing change is most likely due to the exposure of the high-frequency sound or noise.

Thus, the correct answer is a long exposure to high-frequency noise during a 4-hour flight.