Sudden hearing loss with delayed onset following head trauma

Area of Science:

• Otolaryngology
• Neurology
• Trauma Medicine

Background:

• Head trauma is a known cause of inner ear damage.
• Delayed onset of audiovestibular symptoms after trauma is less understood.

Purpose of the Study:

• To investigate the long-term consequences of head trauma on hearing and vestibular function.
• To identify potential underlying pathologies causing delayed symptoms.

Main Methods:

• Case series reporting eight patients with specific head trauma history.
• Surgical exploration in two cases to identify causative lesions.
• Retrospective review of six additional cases with similar clinical courses.

Main Results:

• All patients experienced immediate unilateral deafness and vestibular dysfunction post-trauma.
• Delayed, fluctuating hearing loss and vestibular symptoms occurred in the second ear after 4-33 years.
• Surgical findings included a round window perilymph fistula (15 years post-trauma) and a basal coil cochlear fracture (18 years post-trauma).

Conclusions:

• Head trauma can lead to delayed, progressive sensorineural hearing loss and vestibular dysfunction in the contralateral ear.
• Perilymph fistulas and cochlear fractures are potential, long-standing sequelae of head trauma.
• These findings have implications for diagnosis, treatment, and medico-legal considerations.