[Horton's disease and corticosteroid-responsive hearing loss]

Area of Science:

• Rheumatology
• Otolaryngology
• Neurology

Background:

• Temporal arteritis (TA), an inflammatory panarteritis affecting large arteries, typically occurs in the elderly.
• While often presenting with classic symptoms, 5-10% of TA patients exhibit nonclassical manifestations.
• Hearing loss is a rare but significant nonclassical presentation of TA.

Observation:

• Two new cases of sudden, bilateral, and corticosteroid-responsive hearing loss associated with TA are presented.
• In one case, hearing loss preceded the diagnosis of temporal arteritis.
• Literature review identified 18 previously reported cases of TA and deafness.

Findings:

• Sensorineural hearing loss can be the initial presenting symptom of temporal arteritis.
• The mechanism of deafness in TA is likely due to vertebrobasilar or cochleovestibular arteritis.
• Diagnosis of TA can be challenging, particularly when hearing loss is the sole or primary symptom.

Implications:

• Early recognition of sensorineural hearing loss as a potential TA symptom is crucial.
• Prompt diagnosis and treatment of TA may lead to partial or complete hearing recovery in 55% of cases.
• This highlights the importance of considering TA in elderly patients with unexplained hearing loss.