Traces of perilymph detected in epipharyngeal fluid: perilymphatic fistula as a cause of sudden hearing loss diagnosed with beta-trace protein (prostaglandin D synthase) immunoelectrophoresis

2001 ◽  
Vol 115 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Gregor Bachmann ◽  
Marco Nekic ◽  
Olaf Michel
Keyword(s):  
Hearing Loss ◽  
Sudden Hearing Loss ◽  
Oval Window ◽  
Sudden Sensorineural Hearing Loss ◽  
Unilateral Hearing Loss ◽  
Fluid Sample ◽  
Intravenous Therapy ◽  
Perilymphatic Fistula ◽  
Prostaglandin D Synthase ◽  
The Right

The incidence of perilymphatic fistula as cause of sudden hearing loss is not known. We present a case with sudden unilateral hearing loss associated with a positive β-trace protein test of an epipharyngeal fluid sample. The patient presented with sudden sensorineural hearing loss on the right side. A stapedotomy had been performed nine months previously due to otosclerosis. Intravenous therapy for the treatment of sudden hearing loss was unsuccessful. At the time of sudden hearing loss, epipharyngeal fluid was collected using a Raucocel sinus pack. Investigation using rocket immunoelectrophoresis showed the presence of β-trace protein. Upon repeating tympanoscopy there was no obvious labyrinthine fluid egress, but the oval window was sealed with fibrin sponge and fibrin glue. The patient’s hearing improved over a period of five months.

Oval window perilymph fistula in child with recurrent meningitis and unilateral hearing loss

2020 ◽  
Vol 13 (7) ◽  
pp. e234744
Author(s):  
Miane Min Yan Ng ◽  
Felice D'Arco ◽  
Raouf Chorbachi ◽  
Robert Nash
Keyword(s):  
Hearing Loss ◽  
Oval Window ◽  
Fat Grafting ◽  
Csf Leak ◽  
Unilateral Hearing Loss ◽  
Upper Respiratory Tract ◽  
Recurrent Meningitis ◽  
Newborn Hearing ◽  
Blind Sac Closure ◽  
The Right

A 2-year-old boy presented to Ears, Nose and Throat (ENT) surgeons with unilateral hearing loss. Following a prodrome of upper respiratory tract infection (URTI), he developed two episodes of pneumococcal meningitis in quick succession. This case demonstrates an unusual cause of perilymph fistula diagnosed on imaging and confirmed surgically. He had failed the Newborn Hearing Screening Programme and was therefore referred to audiology, who confirmed profound sensorineural hearing loss in the right ear. MRI showed incomplete partitioning (type 1) of the right cochlea, suggesting cerebrospinal fluid (CSF) leak from the region of the stapes. Exploratory tympanotomy confirmed this, and proceeded to CSF leak repair, obliteration of the Eustachian tube, subtotal petrosectomy, abdominal fat grafting and blind sac closure. Although middle ear effusions are common; particularly in children with recent URTI, the possibility of otogenic CSF leak needs to be considered, especially in cases of recurrent meningitis.

scholarly journals The Relationship Between Sudden Sensorineural Hearing Loss, Vestibular Neuritis, and Infection With COVID-19

2021 ◽  
Author(s):  
Saeid Aarabi ◽  
Nasrin Yazdani ◽  
Javad Fakhri ◽  
Vida Rahimi ◽  
Parsa Cheraghipour ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Pure Tone Audiometry ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Vestibular Neuritis ◽  
Rt Pcr ◽  
The Relationship ◽  
Pcr Test

Introduction: This study aimed to investigate the relationship between sudden sensorineural hearing loss, vestibular neuritis, and infection with COVID-19. Materials and Methods: In this study, a total of 56 Iranians (32 females and 24 males) with a Mean±SD age of 45.12±14 years were studied in Tehran City, Iran. Individuals diagnosed with Sudden Sensorineural Hearing Loss (SSNHL) or vestibular neuritis based on definitive diagnostic criteria were included in the study. The methodology comprised four sections of underlying Sudden Hearing Loss,, auditory and vestibular inspection, SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, and statistical analysis. Also, the videonystagmography test was used in participants with vertigo to diagnose vestibular neuritis. Pure tone audiometry confirmed SSNHL in some patients with a complaint of hearing loss. Furthermore, tuning fork, Rinne and Weber tests were also performed. Results: The results of SARS-CoV-2 RT-PCR in 56 subjects showed that eight subjects (22.2%) with vestibular neuritis and two with SSNHL (10%) had a positive RT-PCR test. The Chi- square and Fisher exact-tests with a 95% confidence interval revealed no statistically significant (P>0.05) relationship between COVID-19 infection and vestibular neuritis or SSNHL. Conclusion: The present study showed no statistically significant relationship between audiovestibular disorders and positive SARS-CoV-2 RT-PCR test. However, the possibility of this relationship cannot be ruled out, and there is a need for studies with larger sample sizes.

Sudden Deafness and Labyrinthine Window Ruptures

1973 ◽  
Vol 82 (1) ◽  
pp. 2-12 ◽  
Author(s):  
Victor Goodhill ◽  
Irwin Harris ◽  
Seymour J. Brockman ◽  
Oscar Hantz
Keyword(s):  
Hearing Loss ◽  
Surgical Intervention ◽  
Round Window ◽  
Vestibular Function ◽  
Sudden Hearing Loss ◽  
Oval Window ◽  
Sudden Deafness ◽  
Scala Tympani ◽  
Cochlear Aqueduct ◽  
History Of

In 1971, one of the authors reported sudden deafness associated with labyrinthine window membrane ruptures. Eighteen additional cases have been explored surgically since then. Data on 21 cases are presented. Sudden profound cochlear deafness has now been encountered in 21 cases which were surgically explored. In 15 instances, fistulae of round, oval, or both windows were encountered and repaired. In 10 of the 15, there was a definite history of sudden exertion or trauma prior to onset. The oval window alone was ruptured in nine patients, the round window alone in one, and both windows were ruptured in five patients. The oldest patient was 62 years and the youngest 11 years of age. Differential audiological studies showed profound losses in all cases. Almost every case was studied by pure tone AC-BC and speech audiometry, Békésy, and impedance tests. Whenever possible other audiologic tests, such as recruitment, tone decay, and SISI were performed. These findings are presented in detail. Vestibular function was studied by electronystagmography (ENG) in 15 of the 21 cases surgically explored. There was evidence of vestibular dysfunction in almost every case with sudden hearing loss. Significant ENG details are presented. Surgical repairs of ruptured window membranes were followed by improvements in some of the patients. Postoperative audiologic data are presented. The theoretical aspects include discussion of possible cerebrospinal fluid (CSF) perilymph pathways between cochlear aqueduct and scala tympani and between internal auditory meatus and scala vestibuli. It is concluded that spontaneous labyrinthine window ruptures must now be added to the etiologic factors in “sudden hearing loss.” It is premature to set down criteria for surgical intervention in such cases. Further careful studies are necessary.

Sudden hearing loss in intralabyrinthine haemorrhage in a child

2004 ◽  
Vol 118 (6) ◽  
pp. 450-452 ◽  
Author(s):  
Chul Ho Jang ◽  
Young Ho Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Unusual Case ◽  
Previous History ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Bleeding Disorders ◽  
Resonance Imaging ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

This paper reports an unusual case in which aseptic meningitis presented with sudden sensorineural hearing loss (SSNHL) associated with intralabyrinthine haemorrhage (ILH). A seven-year-old girl presented with sudden right-sided hearing loss with dizziness. She did not have a previous history of bleeding disorders. This child was assessed using audiograms and magnetic resonance imaging (MRI). The patient's hearing loss was irreversible. Steroid therapy was not effective. SSNHL associated with ILH can be one of the negative prognostic factors in children.

scholarly journals Early Posttreatment Audiometry Underestimates Hearing Recovery after Intratympanic Steroid Treatment of Sudden Sensorineural Hearing Loss

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Wycherly ◽  
Jared J. Thompkins ◽  
H. Jeffrey Kim
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Speech Discrimination ◽  
Case Review ◽  
Retrospective Case ◽  
Hearing Recovery ◽  
History Of

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.

scholarly journals Cochlear Implants as a Treatment Option for Unilateral Hearing Loss, Severe Tinnitus and Hyperacusis

2015 ◽  
Vol 20 (Suppl. 1) ◽  
pp. 60-66 ◽  
Author(s):  
Angel Ramos Macías ◽  
Juan Carlos Falcón González ◽  
Manuel Manrique ◽  
Constantino Morera ◽  
Luis García-Ibáñez ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
Sudden Hearing Loss ◽  
Unilateral Hearing Loss ◽  
Long Term Effects ◽  
Activation Data ◽  
Fitting In ◽  
Severe Tinnitus

Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear™ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.

Sudden sensorineural hearing loss as the first manifestation of chronic myeloid leukaemia: case report

2014 ◽  
Vol 128 (11) ◽  
pp. 1015-1017 ◽  
Author(s):  
M Diao ◽  
F Tian ◽  
J Sun
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Chronic Myeloid Leukaemia ◽  
Sensorineural Hearing Loss ◽  
Myeloid Leukaemia ◽  
Pure Tone Audiometry ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Haematological Disorders

AbstractBackground:Sudden sensorineural hearing loss rarely occurs in patients with chronic myeloid leukaemia.Case report:We present a case report of a patient who presented with sudden sensorineural hearing loss as the first manifestation of chronic myeloid leukaemia, and review the mechanisms responsible for sudden sensorineural hearing loss in leukaemic patients.Results:A 31-year-old female presented to our clinic with unilateral sudden sensorineural hearing loss and tinnitus. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear at all frequencies. During an investigation into her hearing loss, the patient was found to have chronic myeloid leukaemia.Conclusion:Every case of sudden sensorineural hearing loss must be carefully evaluated, and haematological disorders must be considered in the differential diagnosis of sudden hearing loss.

scholarly journals Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Alessandra Fioretti ◽  
Giorgia Peri ◽  
Alberto Eibenstein
Keyword(s):  
Hearing Loss ◽  
Cranial Nerves ◽  
Sudden Hearing Loss ◽  
Empty Sella ◽  
Anterior Inferior Cerebellar Artery ◽  
Fitting Procedure ◽  
Patient Reported ◽  
Combination Device ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI) resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA) and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator). Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients.

Sudden sensorineural hearing loss: when is it idiopathic?

2010 ◽  
Vol 124 (6) ◽  
pp. 690-693 ◽  
Author(s):  
H Wilson ◽  
D J Alderson
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Preliminary Investigation ◽  
Liver Function Tests ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Relative Uncertainty ◽  
The Right

AbstractObjective: To highlight the importance of assessing the certainty of a diagnosis of idiopathic sudden sensorineural hearing loss, and of modifying patient management accordingly.Case report: A patient presented with sudden sensorineural hearing loss in the right ear. Following assessment and preliminary investigation, a diagnosis of idiopathic sudden sensorineural hearing loss was made. Steroid treatment was commenced. Two weeks later, the patient experienced sudden sensorineural hearing loss in the left ear, and scalp tenderness. Subsequent biopsy confirmed giant cell arteritis.Conclusions: Management of idiopathic sudden sensorineural hearing loss should be guided by the level of certainty of diagnosis. If there is relative uncertainty, risk factors for specific diagnoses should be sought, the patient should be followed more closely, and investigation should be tailored appropriately. Giant cell arteritis should be considered in patients older than 50 years, those exhibiting suggestive signs or symptoms, and those with elevated inflammatory markers or deranged liver function tests.

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