Cases reported "Hearing Loss, Sudden"

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1/4. Sudden unilateral hearing loss with simultaneous ipsilateral posterior semicircular canal benign paroxysmal positional vertigo: a variant of vestibulo-cochlear neurolabyrinthitis?

    We describe 4 patients who all simultaneously developed a sudden total or partial unilateral sensorineural hearing loss and an unusual acute peripheral vestibulopathy in the same ear characterized by posterior semicircular canal benign paroxysmal positional vertigo with intact lateral semicircular canal function. Two patients also had ipsilateral loss of otolith function. The vertigo resolved in all 4 patients after particle-repositioning maneuvers. The findings of audiometry and vestibular tests indicated that the lesion responsible for this syndrome was probably located within the labyrinth itself rather than within the vestibulocochlear nerve and that it was more likely a viral vestibulocochlear neurolabyrinthitis than a labyrinthine infarction.
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keywords = labyrinthitis
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2/4. The value of enhanced magnetic resonance imaging in the evaluation of endocochlear disease.

    BACKGROUND: gadolinium-enhanced magnetic resonance imaging (GdMRI) is routinely used in the evaluation and management of suspected retrocochlear pathology such as vestibular schwannoma. However, its value in the evaluation and diagnosis of cochlear pathology associated with sensorineural hearing loss (SNHL) has been less clear. STUDY DESIGN: Retrospective review of case histories and imaging studies of patients with SNHL and cochlear enhancement on GdMRI diagnosed between 1998 and 2000. RESULTS: Five patients with SNHL who required gadolinium administration to establish the diagnosis of endocochlear disease were identified. Diagnosed lesions included an intralabyrinthine schwannoma, intracochlear hemorrhage, radiation-induced ischemic change, autoimmune labyrinthitis, and meningogenic labyrinthitis. In these illustrative cases, the GdMRI demonstrated intrinsic high signal or contrast enhancement within the cochlea and labyrinth in the absence of a retrocochlear mass. In one patient with meningogenic labyrinthitis, cochlear enhancement on MRI led to prompt cochlear implantation before the potential development of cochlear ossification. CONCLUSION: Our experience suggests that GdMRI plays a crucial role in the diagnosis of cochlear pathology associated with sensorineural hearing loss and may directly impact patient management.
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keywords = labyrinthitis
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3/4. The progression of hearing loss in the early stages of sudden deafness.

    The pathogenesis of sudden deafness is still not known. Therefore, to clarify its pathophysiology, it is important to know whether the progression of hearing loss occurs in the early stage of sudden deafness. The subjects were 11 patients with sudden deafness showing the progression of hearing loss by pure tone audiometry after the onset of the initial attack of hearing loss. The progression of hearing loss was mostly observed within 4-7 days after the onset of the initial attack. Average hearing loss in initial audiometry was severe and the recovery was poor in the majority of cases. An exploratory tympanotomy was performed in five cases and revealed one case of perilymphatic leak from the round window and another case of suspected round-window membrane rupture. As far as the causes of the progression of hearing loss in the early stage of sudden deafness are concerned, the following could be considered (1) aggravation of viral labyrinthitis, (2) aggravation of the vascular lesion of the inner ear, and (3) rupture of the membranous labyrinth of window(s).
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keywords = labyrinthitis
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4/4. mumps labyrinthitis, endolymphatic hydrops and sudden deafness in succession in the same ear.

    Acute sensorineural hearing loss, mostly unilateral and reversible, is a well-known complication to mumps. Secondary endolymphatic hydrops, Meniere's syndrome, has rarely been associated with a previous mumps infection. This paper presents the case report of a woman who experienced unilateral hearing loss, vestibular symptoms and a caloric depression on the same ear during mumps. The symptoms and findings were reversible. Twelve years later she developed Meniere's symptoms in the same ear. This continued for 2 years after which she suddenly had a sensorineural hearing loss. This was localized in the mid- and high-tone area and was almost identical with the initial hearing loss 14 years earlier. Viral damage to the resorptive structures of the inner ear seems to have caused the hydrops. It also seemed to have weakened the neuronal structures of the ear, letting the initial damage become overt after repeated attacks of pathological pressure changes.
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ranking = 0.8
keywords = labyrinthitis
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