Author(s)
Naushad M. Khakoo MD
Charles I. Woods MD
Affiliation(s)
SUNY Upstate College of Medicine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss a rare etiology of sudden hearing loss including the diagnostic workup and relevant medical management. Objectives: To discuss a rare etiology of sudden hearing loss including the diagnostic workup and relevant medical management. Study Design: Case report and literature review. Methods: Review of the medical records of a 36 year old male with history of obstructive sleep apnea with noncompliance to therapy and prior left sided hearing loss, who presented with acute onset right (contralateral) hearing loss, bilateral tinnitus, intermittent vertigo; he also stated worsening vision over the prior year. Results: Physical examination showed severe conjunctival injection along with bilateral middle ear effusions and profound mixed hearing loss on audiometry. Hematology revealed an elevated hematocrit and after further workup he was diagnosed with profound erythrocytosis with hyperviscosity syndrome. CPAP, aspirin and phlebotomy were started with subjective improvement in vision and a 15-20dB improvement in hearing in the right ear on repeat testing. Conclusions: Sensorineural hearing loss secondary to erythrocytosis is a rare occurrence, with only case reports described in the literature. Diagnosis requires exclusion of possible neoplastic and endocrine etiologies, and workup for cardiovascular and neurologic sequelae. Awareness of the higher incidence of hearing loss in patients with obstructive sleep apnea along with prevalence of erythrocytosis in this population may be important in further workup and eventual treatment.