Mind the Gap

Question:    A 19 year old male patient is referred to you for conductive hearing loss.  Audiometry reveals mixed hearing loss with a 30 dB ABG and Carhartt notch.  He is interested in surgery but is worried that his procedure will "fail" like his father's did.  What is your next step in the workup of this patient?  [Answer will be posted with next week's new question]

Answer to last week's question, Shouldering the Burden? (November 30, 2015): 

Physical therapy.  Accessory nerve weakness commonly presents with shoulder discomfort and joint pain.