Clinical manifestations of otological syphilis

One patient with early otological syphilis and five patients with late otological syphilis are described including audiological and serological findings. In patients with late syphilis poorer than expected speech discrimination scores relative to the pure tone audiograms were noted. Profound hypo-activity of vestibular responses to caloric stimulation was present in the cases of late otological syphilis. Routine non-treponemal serological tests were not sensitive enough to establish the diagnosis. It is recommended that more sensitive treponemal serological tests such as the FTA-ABS should be employed.