instruction: hello doctor I have a chronic migraine for almost five months now no medicines or treatments have worked and transferring to a hospital with more resources soon over the past few years I have noticed that I am having more and more trouble hearing you could knock walk into the room and ask me something and I will not know you are there alarms will go off in other rooms for more than ten minutes and only after I am aware they are there and I actively try and hear it else will I hear it at all the bell in my high school has gone off and I have not noticed it if I listen to the audio without subtitles I cannot figure out what is being said I cannot understand the phone calls and often in conversation if someone does not speak clearly and at a good volume I will not be able to hear and understand what they are saying at all I also have occasional pain in my inner ear the pressure that feels as though my ears clogged even if they are not the other day my hearing was tested at an ent and they told me my hearing is perfect and that auditory processing disorder and was a possible answer but that if so there would not anything to do I have looked into and it was described as almost auditory dyslexia which does not sound like an accurate description of what I am dealing with it is hard to process what could be going on based on the fact that my ears were tested to be in perfect help if you have any insight or advice I would love some guidance
output: hi auditory processing disorder could be the possible reason but before that the initial level of otosclerosis spongy bone formation in the middle ear ossicle restricts the sound transmission middle ear infection should be ruled out my advice is to consult with an audiologist available nearby please undergo pure tone audiometry speech audiometry impedance audiometry bear test brain stem evoked response audiometry if possible go for hrct temporal bone high resolution computed tomography also that will give us a much clearer picture of your problem if everything is fine then it is attention towards the sound that should be taken into an account