The First Cases of Sudden Sensorineural Hearing Loss Post Coronavirus Disease in Children

To investigate the incidence, characteristics, diagnosis, treatment, and prognosis of coronavirus disease (COVID-19)-related sudden sensorineural hearing loss (SSNHL) in children, three cases of SSNHL after COVID-19 infection in children were analyzed. ENT clinical examination of all cases was normal. Only the third child had a first degree left-beating optokinetic nystagmus, compatible with right peripheral vestibulopathy. The audiogram indicated unilateral severe SSNHL in all frequencies. Computed tomography and magnetic resonance imaging of the brain and temporal bones also showed absence of pathology of the related structures. Oral methylprednisolone was administered to the first two cases, whereas intravenous methylprednisolone in a tapering form was administered to the third case. Additionally, the children underwent intratympanic dexamethasone injections and hyperbaric oxygen therapy with hearing improvement in lower and middle frequencies. The prognosis of COVID-19-related SSNHL in children is closely related to the onset of treatment. The combination of glucocorticoids, intratympanic dexamethasone injections, and hyperbaric oxygen therapy could be effective for COVID- 19-related SSNHL in children. Further large-scale, multicenter studies should be conducted to investigate the pathophysiology, diagnosis, treatment, and prognosis of COVID- 19-related SSNHL.