Bilateral Sudden Sensorineural Hearing Loss and Intralabyrinthine Hemorrhage in a Patient With COVID-19

Otol Neurotol. 2021 Jan;42(1):e10-e14. doi: 10.1097/MAO.0000000000002860.

Abstract

Objective: To describe a case of bilateral sudden sensorineural hearing loss (SSNHL) and intralabyrinthine hemorrhage in a patient with COVID-19.

Study design: Clinical capsule report.

Setting: Tertiary academic referral center.

Patient: An adult woman with bilateral SSNHL, aural fullness, and vertigo with documented SARS-CoV-2 infection (IgG serology testing).

Interventions: High-dose oral prednisone with taper, intratympanic dexamethasone.

Main outcome measures: Audiometric testing, MRI of the internal auditory canal with and without contrast.

Results: A patient presented with bilateral SSNHL, bilateral aural fullness, and vertigo. Serology testing performed several weeks after onset of symptoms was positive for IgG COVID-19 antibodies. MRI showed bilateral intralabyrinthine hemorrhage (left worse than right) and no tumor. The patient was treated with two courses of high-dose oral prednisone with taper and a left intratympanic dexamethasone injection, resulting in near-resolution of vestibular symptoms, a fluctuating sensorineural hearing loss in the right ear, and a severe to profound mixed hearing loss in the left ear.

Conclusions: COVID-19 may have otologic manifestations including sudden SSNHL, aural fullness, vertigo, and intralabyrinthine hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use
  • COVID-19 / complications*
  • Dexamethasone / administration & dosage
  • Female
  • Hearing Loss, Bilateral / virology
  • Hearing Loss, Sensorineural / virology*
  • Hearing Loss, Sudden / virology
  • Hemorrhage / virology*
  • Humans
  • Injection, Intratympanic
  • Labyrinth Diseases / virology*
  • Prednisone / therapeutic use
  • SARS-CoV-2

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone
  • Prednisone