Results
Over the period under examination, three adult patient cases were
reviewed.
The first patient was a 30-year-old lady who worked as an Audiologist in
our hospital. She developed left-sided SSNHL on 5th March 2019,
associated with ipsilateral sensation of aural fullness and distorted
speech. She had a past medical history of migraines, for which she took
prophylactic propranolol. She presented to medical services two days
after symptom onset. Otoscopy was unremarkable, and a pure tone
audiogram (PTA) showed a low frequency hearing loss in the left ear, on
a background of mild bilateral high frequency hearing loss (Figure 1).
The high frequency hearing loss had been documented on a PTA a year
earlier and was unchanged. She was prescribed a week of oral steroids
and subsequent review showed complete recovery (Figure 1). Two months
later the patient experienced a recurrence of left-sided SSNHL, which
also resolved following a week of oral steroids. In view of the
recurrent episodes, further investigations were arranged after symptom
resolution. These results were unremarkable, including serum thyroid
function, haematology, erythrocyte sedimentation rate, anti-neutrophil
cytoplasmic antibody levels, and Lyme disease serology, and normal MRI
of the internal auditory meati.
The second patient was a 61-year-old lady who worked as secretarial
support for the audiology department. She developed right-sided SSNHL on
13th May 2019 without associated symptoms. She had a past medical
history of Type 1 diabetes mellitus. The patient presented to medical
services a day after the onset of her symptoms. Otoscopy was normal. PTA
showed low frequency sensorineural hearing loss on the right side and
normal hearing on the left (Figure 2). The decision was made to proceed
with intratympanic rather than oral steroid therapy so that serum
glucose control would not be perturbed. Four intratympanic injections
were initially scheduled, each 2-3 days apart, but were discontinued
after the second injection due to complete symptom resolution and return
of hearing to normal (Figure 2). No subsequent investigations took place
and there have not been any further symptoms.
The third patient was a 24-year-old man who also worked as secretarial
support for the audiology department. He developed right-sided SSNHL a
couple in late March 2019. but did not present to clinic until 18th July
2019. He did not seek medical advice at the time of symptom onset, as he
attributed his hearing loss to wax accumulation. He had no associated
otological symptoms, and there was no past medical, surgical or
medication history of note, however his mother had worn bilateral
bone-anchored hearing aids. Otoscopy was normal. PTA demonstrated low
frequency sensorineural hearing loss on the right side, with normal
hearing on the left (Figure 3). In view of his delayed presentation, he
was not offered oral steroids but was investigated with MRI, which
showed normal internal auditory meati. There has been no resolution of
hearing in this patient to date (Figure 3).
There have been no further cases in our audiology department since July
2019.