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Margaret is a retired 59 year old teacher who presents with a 2 hour history of a ‘funny buzzing sound’ in her right ear. She noticed this suddenly after breakfast and it has been ongoing since as if rhyming in time with her heartbeat. There is no hearing loss, earache or history of head trauma or recent travel. There are no neurological symptoms. Past medical history includes Type 2 Diabetes Mellitus which is well controlled on Metformin.

On examination, both ears are normal on examination and cranial/upper and lower limb neurological exams are also unremarkable. You are unable to locate the tuning fork to carry out Rinne and Weber’s test.

What is the most appropriate next course of action?

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