Temporal Arteritis as a Differential Diagnosis of Unilateral, Sensorineural Hearing Loss

Introduction: Temporal arteritis, also known as giant cell arteritis, is an inflammatory vasculitis that affects large and medium arteries of the head, mostly branches of the external carotid artery. Most patients are older than 55 years, and its incidence is more common among women than men (2:1 ratio).

Objective: The study aims to describe a case unilateral sensorineural hearing loss secondary to temporal arteritis.

Case report: The authors describe a case of a 63-year-old male patient presented with rapidly progressive hearing loss on the left ear in the past 30 days. Audiological assessment revealed bilateral sensorineural hearing loss, classified as mild on the right side and moderate on the left side. The evaluation of the cerebellopontine angle by MRI scan was normal. There were no vestibular complaints, but tenderness in the left temporal region was observed. Simultaneously, the patient was being submitted to ophthalmological assessment for visual disorder involving the left eye. Laboratory evaluation revealed an erythrocyte sedimentation rate (ESR) of 80 mm/h. The patient met the clinical criteria for the diagnosis of temporal arteritis. Treatment with oral prednisone normalized auditory thresholds in the left ear, as documented on serial audiometric tests.

Conclusion: Temporal arteritis has been largely related to visual disturbances. However, sensorineural hearing loss has been rarely reported. The presence of visual complaints, tenderness in the temporal region, and elevated ESR were crucial for definitive diagnosis and effective therapeutic management.

Keywords: temporal arteritis, hearing loss, erythrocyte sedimentation rate.