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Mr Cook is a 68 year old male who is well known to most of the doctors at the practice with obesity, Hypertension and Type 2 Diabetes. He has requested a routine appointment to discuss recurrent episodes of ‘buzzing in his right ear’. He explains that over the last three months, he has noticed a buzzing noise which is most apparent when waking in the morning and is exacerbated by stress. He denies any dizziness, vertigo or earache. He does complain of some right sided hearing loss which he believes started suddenly around 2 months ago and has since stayed the same. He has not had any intercurrent illnesses and his blood pressure and Diabetes are currently well controlled. ENT/neurological examinations are unremarkable.

What is the most appropriate next step in management?

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