Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With Covid-19

Abstract

Although peripheral facial paralysis and sudden sensorineural hearing loss are not as common as anosmia, they are reported neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We present a 62-year-old, serologically COVID-19 positive woman with seventh and eighth nerve involvement showed electrophysiologically with Auditory Brainstem Response and electroneurography and radiologically with internal acoustic canal magnetic resonance imaging. This single case report suggests a possible association between the SARS-CoV-2 infection with simultaneous sudden sensorineural hearing loss and isolated facial paralysis. However, further studies are needed to determine whether this relationship is coincidental or occasional.

COVID-19 and Sudden Sensorineural Hearing Loss: A Systematic Review

“…Most patients with COVID-19-related SSNHL showed normal MRI findings, while some developed an intra-labyrinthine hemorrhage ( 7 , 13 ). Ozer et al reported a case of SSNHL with peripheral facial paralysis in a COVID-19 patient, suggesting a link between SSNHL and isolated facial paralysis ( 25 ).…”

“…Due to isolation of patients, telephone consultations were also used to provide an initial assessment of the patient's condition ( 13 ). Auditory brainstem response (ABR), otoacoustic emission, and electroneuronography were applied in a few studies ( 25 , 28 ). Two studies used a head-shaking test or video head impulse testing to identify vertigo ( 11 , 27 ).…”

“…Glucocorticoids were the most commonly used therapeutic agents for COVID-19-related SSNHL, and the vast majority of patients were treated with glucocorticoids. Corticosteroids can be delivered orally, intravenously, or intramuscularly via systemic and/or intratympanic (IT) routes ( 12 , 25 , 27 ). In one study, five patients received hyperbaric oxygen therapy (HBOT) and oral mesoglycan as an adjunctive treatment ( 11 ).…”

Tinnitus, Sudden Sensorineural Hearing Loss, and Vestibular Neuritis As Complications of the Astra Zeneca COVID-19 Vaccine

“…Although more evidence is yet to be found, the temporal relation between the AZCV exposure and the appearance of hearing loss and tinnitus a few days after the vaccination in all cases clearly points toward a likely association between the vaccine and the otologic symptoms. Many authors have considered a possible link between COVID-19 infection and SSHL [ 2 , 6 - 10 ]; however, as far as the author knows this is the first case series considering the possible association between a COVID-19 vaccine and inner ear damage, which could indeed have pathophysiology similar to that of the cases of SSHN secondary to COVID-19 infection. We display the audiometries of cases 1 and 5 since we believe them to be the most representative of the situation described by Tseng et al [ 12 ] (case 1) and the one described by Tsetsos et al [ 11 ] (case 5).…”

“…Several previous reports have mentioned the possible link between COVID-19 infection and inner ear damage [2,[6][7][8][9][10]; however to the authors´ very best knowledge this is the first case series considering the possible association between AZCV (or any COVID-19 vaccine) and inner ear damage, and so far only two previous isolated single case reports of auditory symptoms related to the AZCV have been described, including one report of SSHL itself [11], and one report of tinnitus presumably associated to cochleopathy secondary to the vaccine [12]. To our best knowledge, this is the first report of a patient with vestibular symptoms related to the AZCV.…”