Recurrent sudden sensorineural hearing loss sensitive to transtympanic and systemic steroid treatment: case report

Sudden sensorineural hearing loss (SSNHL) is a rare otologic emergency. Recurrence of this pathology is extremely rare, and its incidence remains unknown. We report the case of a previously healthy 28-year-old man with normal findings on bilateral ear examination who presented with severe unilateral SSNHL. Audiometry demonstrated a pure-tone average of 70 dB and a speech discrimination score of 0% in the affected ear. The patient was treated within hours of the onset of symptoms with an intratympanic injection of dexamethasone and then started on a tapered course of oral prednisone. He experienced a full recovery based on repeat audiometric testing 7 days later. However, 1 year later, the patient experienced a repeat episode of SSNHL in the same ear. Management again included an intratympanic injection and an oral steroid course with good results. A complete metabolic and radiographic evaluation failed to identify a cause of the hearing loss. This case represents a highly unusual instance of recurrent SSNHL of unknown etiology.