Laryngorhinootologie 2024; 103(S 02): S288
DOI: 10.1055/s-0044-1784964
Abstracts │ DGHNOKHC
Otology/Neurootology/Audiology: Neurootology/Vertigo

Sudden bilateral hearing loss – an unusual cause

Authors

  • Hannah Lukasik

    1   Ruhr-Universität Bochum, Johannes Wesling Klinikum, Klinik für Hals-, Nasen-, Ohrenheilkunde und Kopf-Hals-Chirurgie, Minden

  • Stijn Bogaert

    2   Ruhr-Universität Bochum, St. Elisabeth Hospital, Bochum

  • Ruth Roggel

    3   Mühlenkreiskliniken im Johannes Wesling Klinikum Minden, Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Minden

  • Alexey Surov

    3   Mühlenkreiskliniken im Johannes Wesling Klinikum Minden, Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Minden

  • Stefan Volkenstein

    1   Ruhr-Universität Bochum, Johannes Wesling Klinikum, Klinik für Hals-, Nasen-, Ohrenheilkunde und Kopf-Hals-Chirurgie, Minden
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    Introduction Sarcoidosis is a chronic disease of unclear etiology associated with the formation of non-caseating granulomas. Pulmonary, ocular or lymphatic manifestations are most common. Rarely, there are neurological symptoms (about 5%). If neurosarcoidosis is present, it usually affects the facial or optic nerve. Hearing disorders are present in only 20% of cases.

    Methods A 67-year-old patient presents to our clinic with a right-sided hearing loss and vertigo that has been present for one year. The initial improvement of hearing under cortisone soon worsened. For several weeks, the patient experienced a hearing loss on the left side as well.

    Results Audiometry revealed a hearing loss close to surditas on the right side (100-120 dB) and a pantonal sensorineural hearing loss on the left side of 60 dB with left-sided vestibular hypoexcitability. No AEP's could be derived on the right side in the ABR. The cMRI showed a thickening of the leptomeninges of unclear etiology. We performed a whole body CT and a MRI of the skull and spine. This revealed pulmonary bihilary lymphadenopathy with granuloma formation. In the BAL, tuberculosis could be excluded. The CD4/CD8 quotient was elevated. In conclusion, the diagnosis of sarcoidosis with neural involvement (neurosarcoidosis) was made.

    Discussion Neurosarcoidosis is a rare differential diagnosis of hearing impairment. Due to limited histological acquisition, it is a diagnosis of exclusion and is made on the basis of clinical and radiological criteria. Treatment with steroids usually leads to a temporary improvement of hearing. During progression, CI provision is a treatment option for some patients.


     

    Publication History

    Article published online:
    19 April 2024

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