Images in Otorhinolaryngology
Posterior semicircular canal involvement in sudden hearing loss
Afectación del canal semicircular posterior en la sordera súbita
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Martínez Arias" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Elena" "apellidos" => "Dina" "email" => array:1 [ 0 => "Elena.dina@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Mario" "apellidos" => "Prenafeta Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Àngels" "apellidos" => "Martínez Arias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Consorci Coproració Sanitaria Parc Taulí, Otolaryngology Department, Sabadell, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Consorci Corporació Sanitaria Parc Taulí, Department of Radiodiagnosis and Imaging, Sabadell, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Afectación del canal semicircular posterior en la sordera súbita" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1908 "Ancho" => 3341 "Tamanyo" => 457791 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 42 year-old man without cardiovascular risk factors or significant pre-existing conditions presented sudden hearing loss (SHL) in his left ear accompanied by vertigo. 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.</p><p id="par0010" class="elsevierStylePara elsevierViewall">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.</p><p id="par0015" class="elsevierStylePara elsevierViewall">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.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">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>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Transient ischemia of the common cochlear artery was suspected, with worse impact on the posterior vestibular branch territory.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Involvement only of the PSC in SHL is rare, with only one case reported of acute filling defect on MRI secondary to ischemia.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Ossification due to infarction of the PSC was also described in one case although without hearing loss.</p><p id="par0040" class="elsevierStylePara elsevierViewall">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.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Recent research demonstrates that damage to the PSC in SHL predict worse hearing outcome.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1908 "Ancho" => 3341 "Tamanyo" => 457791 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2105 "Ancho" => 3341 "Tamanyo" => 443733 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000007500000004/v1_202407250620/S2173573524000292/v1_202407250620/en/main.assets" "Apartado" => array:4 [ "identificador" => "5869" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in otorhinolaryngology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000007500000004/v1_202407250620/S2173573524000292/v1_202407250620/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573524000292?idApp=UINPBA00004N" ]