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July 2017

Bilateral Hearing and Vestibular Loss in a Patient With Untreated Chronic Myeloid Leukemia

Author Affiliations
  • 1Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 2Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2017;143(7):736-737. doi:10.1001/jamaoto.2017.0283

In the setting of uncontrolled chronic myeloid leukemia (CML), patients can develop hyperleukocytosis. We present a case of a man in his 40s with untreated CML who presented with sudden-onset positional vertigo and profound right sensorineural hearing loss (SNHL), followed by left SNHL several days later. Bilateral SNHL and vestibular pathology in CML are rare. Although these symptoms are usually attributed to infarctions secondary to hyperviscosity syndrome, the patient did not respond to rapid cytoreduction. In this case study, we explore hemorrhage as an alternate etiology and discuss cochlear implantation and vestibular rehabilitation as treatment plans.

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