Sudden Hearing Loss: Report of Two Cases

Introduction: Sudden hearing loss is defined as hearing loss rapid onset, occurring within 72 hours, in one or both ears, with a sensorineural nature. In audiometry, there is a loss of 30 dB in three consecutive frequencies. The incidence of sudden sensorineural hearing loss is 5 to 20 people per 100,000 in population. The etiology is identified in 10 to 15% of patients. Bilateral deafness is rare and should point to certain specific causes.

Objectives: Present two rare cases of sudden bilateral deafness, with different outcomes.

Methods: Two cases were selected. Both presented with classical picture of cholangitis. They were admitted in different times and with different clinical pictures. Thus, the management differed as well as the outcomes. The case 1 was a 67 year old who had classic symptoms of cholangitis. It evolved to deafness 3 days after. He had uncontrolled diabetes. He was treated with antibiotics and follow-up with serial audiometry before and after treatment with intratympanic corticosteroids. Case 2 was a patient aged 49 with cholangitis who developed sepsis. After 5 days he had deafness. He was treated with antibiotics, oral and intratympanic corticosteroids, and was accompanied with audiometry.

Results: Case 1, due to the delay of diagnosis, active infection, uncontrolled diabetes, and delayed therapy, the patient remained bilateral. Case 2, since he was young, early diagnosis and treatment done with oral and intratympanic corticosteroids had a significant improvement of bilateral hearing.

Conclusion: Bilateral sudden deafness is very rare condition. Individual patient characteristics, etiology, and time of onset and type of treatment are essential to its outcome.