Sudden hearing loss and acquired immunodeficiency syndrome

We have presented a case of a male homosexual with documented acquired immune deficiency syndrome in whom sudden sensorineural hearing loss developed after a series of opportunistic infections and before a massive intracerebral hemorrhage. Two major possible causes of his hearing loss are (1) actual involvement of spiral ganglion or acoustic division of the eighth cranial nerve by HTLV III virus, or (2) cryptococcal meningitis. He ultimately died after a series of neurological complications developed. These complications, which are common in patients with AIDS, include progressive dementia, obtundation, and coma. As the number of patients with AIDS in our society increases over the next 5 years, it will become more important for the otolaryngologist to recognize the complications of this disease that involve the ear, nose, throat, head, and neck. Sudden sensorineural hearing loss is one of these complications. The acquired immune deficiency syndrome, at this point, might best be treated by an approach of preventive medicine. However, such an approach would have far-reaching social and political implications--perhaps more so than in other venereally spread diseases. In the interim, the otolaryngologist-head and neck specialist is required to recognize AIDS as it manifests itself in the head and neck. In this case, sudden-onset sensorineural hearing loss was the otolaryngologic presentation of the AIDS.