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Abstract
Sudden sensorineural hearing loss (SSNHL) is an otologic emergency. Sensorineural hearing loss needs to be distinguished from conductive when patients present with sudden hearing loss at the primary care level. Prompt diagnosis of sensorineural hearing loss with pure tone audiometry and immediate treatment by an otolaryngologist can improve the hearing outcome. To date, few case reports exist about SSNHL among post-COVID-19 patients, and none were reported in Malaysia. Here, we present two cases of SSNHL in patients after COVID-19 infection. We wish to highlight the association of SSNHL following COVID-19 infection for timely referral towards better audiology outcomes. Permanent hearing loss will lead to another negative impact on the long-term quality of life of COVID-19 patients.
Keywords:
COVID-19, Sensorineural, Hearing loss, Vertigo, Labyrinthitis
Introduction
Sudden-onset sensorineural hearing loss (SSNHL) is hearing loss of at least 30 dB in at least three consecutive audiometric frequencies that has developed within 72 hours.1-4 SSNHL is usually unilateral.5-7 The main causes of SSNHL include viral infections, vascular occlusion, abnormal cellular stress responses within the cochlea, and immune-mediated mechanisms.8 Sensorineural hearing loss can be distinguished at the primary care level by examination using an otoscope and testing using a 512-Hz tuning fork.4,9
COVID-19 is a new pandemic caused by a novel coronavirus, SARS-CoV-2. A wide range of complications following COVID-19 infection have been studied, and primary care physicians are directly involved in the rehabilitation of post-COVID-19 patients. SSNHL is a rare complication and should be identified by the primary care team and referred to an otolaryngologist urgently.4,9
Case Presentation
Case 1
A 35-year-old Chinese gentleman presented to the health clinic 8 weeks after contracting COVID-19. He had tested positive for COVID-19 by reverse transcription polymerase chain reaction. He was asymptomatic during the initial diagnosis and classed as Category 1. He had anosmia on day 5 of his illness. He completed his home quarantine with no complications. He presented with sudden hearing loss in the left ear, which had occurred 3 days prior, on awakening. This was associated with vertigo and left aural fullness. He denied any history of trauma, upper respiratory infection, exposure to loud noise, recent air travel or taking any regular medication before the onset of hearing loss. He had worked as an engineer in the...