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Clinical Problem Solving
January 2015

An Unusual Cause of Sudden Hearing Loss

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia
JAMA Otolaryngol Head Neck Surg. 2015;141(1):91-92. doi:10.1001/jamaoto.2014.2785

An African American man in his 40s initially presented with a sudden-onset unilateral hearing loss with associated vertigo and tinnitus. His medical history was unremarkable, and he specifically had no history of any auditory or vestibular symptoms. Results from his physical examination were also unremarkable and demonstrated normal otoscopic and neurologic findings. Audiometry results revealed a moderate right-sided sensorineural hearing loss across all frequencies (250-8000 Hz). Prior audiograms were unavailable for comparison. The patient was treated with tapered prednisone therapy and scheduled for magnetic resonance imaging (MRI) radiographic evaluation. Subsequent clinical and audiology evaluations at 1 week and 1 month demonstrated an almost complete resolution of his hearing loss and vertigo symptoms. His MRI was obtained 2 months after onset of his symptoms with the enhancement pattern shown (Figure).

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