Sudden hearing loss and coronavirus disease 2019: the role of corticosteroid intra-tympanic injection in hearing improvement

Abstract

Background Coronavirus disease 2019 was first seen in December 2019. Due to the insidious and complex nature of the disease, the list of symptoms is rapidly expanding. So far, few studies have reported sudden sensorineural hearing loss as a possible symptom of coronavirus disease 2019. Case report A 60-year-old woman with a complaint of sudden sensorineural hearing loss and subjective severe tinnitus presented to the ENT clinic. Coronavirus disease 2019 was subsequently confirmed with a polymerase chain reaction test. At the time of presentation, she was treated with intra-tympanic dexamethasone. Improvements in hearing threshold and speech perception, and a subjective reduction in tinnitus, were observed after treatment. Conclusion This case report supports evidence from other case reports of a possible association between coronavirus disease 2019 and sudden sensorineural hearing loss. Sudden sensorineural hearing loss may be a symptom of this disease that behaves as an underlying aggravating factor. Intra-tympanic injection of corticosteroids is recommended for managing these patients during the pandemic.

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

“…In these studies, PTA was the most commonly used method of audiological assessment ( 6 , 13 , 35 ). Several studies employed tympanometry and tuning fork tests to identify COVID-19-related SSNHL ( 6 , 35 ).…”

“…In these studies, PTA was the most commonly used method of audiological assessment ( 6 , 13 , 35 ). Several studies employed tympanometry and tuning fork tests to identify COVID-19-related SSNHL ( 6 , 35 ). Due to isolation of patients, telephone consultations were also used to provide an initial assessment of the patient's condition ( 13 ).…”

“…Two studies used a head-shaking test or video head impulse testing to identify vertigo ( 11 , 27 ). The patients' word recognition scores (WRS) were assessed using the speech audiometry method in two studies ( 6 , 7 ). Also, tinnitus handicap inventory and dizziness handicap inventory were used in one study ( 11 ).…”

“…According to the clinical practice guidelines of the American Academy of Otolaryngology-Head and Neck Surgery, glucocorticoids can be used as initial treatment for SSNHL patients within 2 weeks after the onset of the disease ( 4 ). Since there are contradictory results on adverse reactions to corticosteroids in patients with COVID-19, IT administration is a beneficial option ( 6 ). A clinical study compared the therapeutic efficacy of IT corticosteroid administration vs. intravenous corticosteroids in COVID-19-related SSNHL, and found comparable efficacy of both treatments ( 43 ).…”

“…The cause of SSNHL is unclear. However, the possible causes include viral infection, circulatory abnormalities, autoimmune disease, labyrinthine membrane rupture, and central nervous system (CNS) anomalies ( 5 , 6 ).…”