Bilateral Sudden Sensorineural Hearing Loss and Intralabyrinthine Hemorrhage in a Patient With COVID-19

Objective: To describe a case of bilateral sudden sensorineural hearing loss (SSNHL) and intralabyrinthine hemorrhage in a patient with COVID-19. Study Design: Clinical capsule report. Setting: Tertiary academic referral center. Patient: An adult woman with bilateral SSNHL, aural fullness, and vertigo with documented SARS-CoV-2 infection (IgG serology testing). Interventions: High-dose oral prednisone with taper, intratympanic dexamethasone. Main Outcome Measures: Audiometric testing, MRI of the internal auditory canal with and without contrast. Results: A patient presented with bilateral SSNHL, bilateral aural fullness, and vertigo. Serology testing performed several weeks after onset of symptoms was positive for IgG COVID-19 antibodies. MRI showed bilateral intralabyrinthine hemorrhage (left worse than right) and no tumor. The patient was treated with two courses of high-dose oral prednisone with taper and a left intratympanic dexamethasone injection, resulting in near-resolution of vestibular symptoms, a fluctuating sensorineural hearing loss in the right ear, and a severe to profound mixed hearing loss in the left ear. Conclusions: COVID-19 may have otologic manifestations including sudden SSNHL, aural fullness, vertigo, and intralabyrinthine hemorrhage.

Automated summary

This case report describes a patient with COVID-19 who experienced bilateral sudden sensorineural hearing loss and intralabyrinthine hemorrhage. Treatment with high-dose oral prednisone and intratympanic dexamethasone resulted in improvement of vestibular symptoms, fluctuating sensorineural hearing loss in the right ear, and severe to profound mixed hearing loss in the left ear.