Sudden Sensorineural Hearing Loss in a Patient with Hypertension: A Case Report

Sudden sensorineural hearing loss is an otologic emergency, and hypertension is often proposed as a vascular contributor to its onset and poor recovery. Published evidence is inconsistent, and accounts from settings without funded hyperbaric oxygen are limited. This report describes a hypertensive patient and compares the course with recent evidence. A 67-year-old man with treated stage II hypertension presented three days after sudden left hearing loss with tinnitus. His blood pressure was 160 over 100, and otoscopy was normal. Audiometry on day five after onset showed very severe left hearing loss with a mean air conduction threshold of 100 decibels. He received intravenous methylprednisolone, intermittent oxygen, candesartan, and a low-salt diet. Hyperbaric oxygen was not given because insurance did not cover it. By day twelve the left threshold had improved to 73.75 decibels, a gain of 26.25 decibels, which is a slight improvement by the Siegel criteria. A focused literature search found two meta-analyses with inconsistent support for hypertension as a risk or prognostic factor. This case adds an account of limited recovery in a hypertensive older adult under resource constraints and highlights blood pressure monitoring during steroid therapy.