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[Horton's disease and corticosteroid-responsive hearing loss]
D Saadoun1, P Cacoub, N Costedoat-Chalumeau
1Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris Cedex 13.
Annales De Medecine Interne
|January 5, 2001
Summary
Sudden hearing loss can be an early sign of temporal arteritis (TA), a large artery inflammation. Prompt treatment of TA may improve hearing in over half of affected patients.
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.