Sudden sensorineural hearing loss: a case report of labyrinthine hemorrhage

Sudden sensorineural hearing loss is a clinical emergency in which a patient suddenly (within 72 hours) experiences sensorineural hearing loss which is not the result of damage to the outer or middle ear. Inner ear hemorrhage is a rare disease that manifests as a triad of symptoms: acute dizziness, sudden unilateral hearing loss, and tinnitus, often with a poor prognosis for functional recovery. Diagnosis of this condition consists of an otoneurological examination with audiometry and magnetic resonance imaging with contrast enhancement and 3D-FLAIR mode. The article presents a clinical case in which a 72-year-old woman, against the background of increased blood pressure and aspirin intake, acutely developed dizziness, sudden left-sided hearing loss, and tinnitus, which corresponded to acute unilateral sensorineural hearing loss. There was also a violation of the function of the left peripheral vestibular apparatus, and tone audiometry showed profound left-sided sensorineural hearing loss. Magnetic resonance imaging of the brain, including diffusion-weighted imaging, revealed hemorrhage in the labyrinth and signs of cerebral microangiopathy. The patient was treated with corticosteroids, antihypertensive drugs, and vitamins. During the observation period, vestibular function recovered; however, profound hearing loss persisted in the left ear. Current guidelines for the treatment of sudden sensorineural hearing loss recommend the use of corticosteroids for the first two weeks as first-line therapy and do not recommend the routine use of antivirals, vasodilators, and thrombolytics.