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Rapidly progressive hearing loss occurring over weeks: review of differential diagnoses

Published online by Cambridge University Press:  13 October 2021

C W Lee Open the ORCID record for C W Lee [Opens in a new window] ,
H Walters ,
H Steele  and
F Stafford
C W Lee*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
H Walters
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
H Steele
Affiliation:
Department of Neurology, Sunderland Royal Hospital, Sunderland, UK
F Stafford
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sunderland Royal Hospital, Sunderland, UK
*
Author for correspondence: Mr Chang Woo Lee, Department of Otolaryngology – Head and Neck Surgery, Sunderland Royal Hospital, Kayll Road, SunderlandSR4 7TP, UK E-mail: changwoo.lee@nhs.net
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Abstract

Background

Sudden hearing loss, or progressive hearing loss occurring over months to years, are well-established presentations. However, little is described in the medical literature on how to approach patients presenting with a rapidly progressive hearing loss occurring over weeks. This study aimed to evaluate the clinical significance of patients presenting with rapidly progressive hearing loss.

Methods

A case of rapidly progressive hearing loss occurring over 12 weeks is presented. A PubMed literature review was performed to determine the evidence-based differential diagnoses for rapidly progressive hearing loss.

Results

Fifteen causes were identified for rapidly progressive hearing loss: intracranial aetiologies (meningioma, lymphoma, metastatic deposit, cavernous angioma, meningitis, superficial siderosis); paraneoplastic syndrome (small cell lung carcinoma, thymoma); inflammatory or autoimmune disorders (autoimmune inner-ear disease, sarcoidosis, vasculitis, Sjögren's syndrome); infective disorders (syphilis, human immunodeficiency virus); and medication-induced causes.

Conclusion

Rapidly progressive hearing loss should be considered a ‘red flag’ symptom that warrants urgent action. Most causes are systemic or sinister in nature, and the patient's hearing loss can potentially be reversed.

Keywords

HearingOtologyNeuro-OtologyAudiologySkull BaseSurgery
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 775 - 782
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr C W Lee takes responsibility for the integrity of the content of the paper

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