A 50-year-old woman presents with a progressive sense of decreased hearing in her right ear and tinnitus over several years. Her father had hearing problems at a young age but never was evaluated. She denies trauma, noise exposure, or ear disease as a child. Your examination demonstrates a completely normal-appearing tympanic membrane, which is mobile to pneumatic testing. Tuning fork tests show a Weber test that lateralizes to the affected (right) ear. Air conduction is greater than bone conduction of the left; on the right bone conduction is greater than air conduction. What is your diagnosis?
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