Posterior semicircular canal involvement in sudden hearing loss

Dina, Elena; Prenafeta Moreno, Mario; Martínez Arias, Àngels

doi:10.1016/j.otoeng.2024.01.010

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Clinical assessment revealed left side cophosis and vestibular hypofunction. Blood test results were inconclusive. The patient had received a second dose of anti Sars-Cov-2 (Comirnaty) vaccine 2 months earlier.The hearing loss was permanent despite a maximum treatment with concomitant oral steroids and intratympanic dexametasone followed by hyperbaric oxigen therapy. The patient compensated gradually and completely the vestibular impairment.MRI and vestibular testing carried out 4 months later detected an isolated left posterior semicircular canal (LPSC) lack of signal on high resolution T2 sequences (CISS 3D_cs_T2W_DRIVE_HR) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and abnormal low vHIT LPSC gain.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Two years later a temporal bone CT scan discarded ossification and on the MRI the LPSC discreetly improved its signal (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Transient ischemia of the common cochlear artery was suspected, with worse impact on the posterior vestibular branch territory.Involvement only of the PSC in SHL is rare, with only one case reported of acute filling defect on MRI secondary to ischemia.Ossification due to infarction of the PSC was also described in one case although without hearing loss.An MRI within the first month of the onset helps identifying the pathophysiology of the SHL but most of these changes subside within months. However, acute inner ear ischemia is not usually detected.Recent research demonstrates that damage to the PSC in SHL predict worse hearing outcome." 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ISSN: 2173-5735

Acta Otorrinolaringológica Española, the official publication of the Spanish Society of Otolaryngology and Head and Neck Surgery and the Ibero-American Society of Otorhinolaryngology, is the most important journal in Spanish dedicated to Otorhinolaryngology, which reflects the continuous scientific and technical progress of the specialty. It has become an important tool to be kept up to date. The Journal publishes Original Articles (articles on basic research and clinical investigation), reviews, brief communications, case studies and images, which are subjected to a rigorous peer review process.

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0.9

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1.4

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SJR 2023

0.326

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SNIP 2023

0.54

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