Case Study 3

The patient is a 54-year old man who presented with a sudden profound sensorineural hearing loss in his right ear, his only hearing ear. He had lost his hearing in his left ear as a child to unknown causes. The patient reported having lost all hearing on his right side a few days prior to his appointment. He denied any associated vertigo but did complain of a very loud tinnitus on that side.

He had a significant past medical history with poorly-controlled insulin-dependent diabetes, coronary artery disease, hypertension, and obesity.

On exam, his ear canals and tympanic membranes appeared normal. His facial function and vestibulo-ocular reflexes were also normal.

Audiogram revealed bilateral dead ears with 0% word discrimination on both sides.

Oral steroids were contraindicated in this patient secondary to his poorly-controlled diabetes and for this reason, an intra-tympanic dexamethasone treatment was offered. An MRI was ordered to rule-out any tumors and was shown to be negative.

Upon the patient’s return after one week, his hearing on the right side had returned to “normal”- PTA 30dB and 100% WDS. A series of three total intratympanic dexamethasone injections were given and the patient was able to maintain his hearing on the right side.