Acute-Onset Unilateral Psychogenic Hearing Loss in Adults: Report of Six Cases and Diagnostic Pitfalls

Abstract

We encountered 6 rare cases of acute-onset unilateral psychogenic hearing loss in adults. All were women in their 20s and 30s. Three cases had severe hearing impairment characterized by hearing loss at every frequency; 2 cases had profound hearing impairment, and 1 case had low-frequency hearing impairment. Of the 6 cases, 3 had a history of hearing loss, and 1 had a history of psychogenic visual disturbance. All 6 cases were initially diagnosed as having idiopathic sudden sensorineural hearing loss; all subsequently received steroid therapy. Three cases were not diagnosed as being psychogenic in origin until otoacoustic emissions and auditory brain responses were performed. Although the presence of distinctive clinical features (age, gender, and past history) is important for suspecting psychogenic hearing loss, objective audiological tests such as otoacoustic emissions are essential for diagnosing some cases. Compared to the existing reports of similar cases, our cases had a poorer prognosis (only 2 cases were cured).

Analysis of the characteristics of outpatient and emergency diseases in the department of otolaryngology during the “COVID-19” pandemic

“…In 2009, cases of sudden psychogenic deafness related to mental conditions were reported. 18 Contrera et al 19 found out that sudden deafness with moderate or severe conditions is related to the mood of elderly people and these patients also had different conditions of “Somatosensory impairment.” Long-term anxiety, depression and other mental issues may cause the autonomic nervous system to release more neurotransmitters such as norepinephrine and serotonin that lead to vasoconstriction, platelet activation, and blood viscosity increasing. These reactions will cause micro thrombosis and changes of physiological state, resulting in the inner ear microcirculation disorder, leading to sudden deafness by degeneration of the organ of Corti due to hypoxia.…”

Increased risk of sudden sensorineural hearing loss in patients with depressive disorders: population-based cohort study

“…In psychogenic hearing loss, a discrepancy exists between the patient's subjective and objective audiological test results, such as a discrepancy between pure tone audiometry and auditory brainstem response. Although experienced clinicians may easily detect psychogenic hearing loss using conventional audiological procedures, more advanced audiological tests have been used to diagnose psychogenic hearing loss, including auditory brain responses and otoacoustic emissions 18 – 21 . In Taiwan, these subjective and objective audiological tests are widely available, enabling otolaryngologists to diagnose malingering, factitious disorder and psychogenic hearing loss.…”

Pure tone auditory thresholds can change according to duration of interrupted tones in patients with psychogenic hearing loss

“…The diagnoses of PHL, cochlear hearing loss, or retrocochlear hearing loss depended on the following tests: pure tone audiometry, otoacoustic emissions (OAEs), auditory brain response (ABR), and magnetic resonance imaging (MRI) [7]. Normal hearing level in pure tone audiometry was defined as <30 dBHL at all frequencies measured.…”