PMC8250142_01
Time course of vertigo attacks, pure tone audiogram results, and treatments. AC, air conduction; BC, bone conduction; IT, intratympanic; IV, intravenous, LE, left ear, NR, no response; RE, right ear.
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F1
The pure tone audiogram (PTA) demonstrated sensorineural hearing loss (SNHL) in the left ear (Figure 1). The vertigo attacks resolved, and follow-up PTA revealed mild improvement of SNHL in the left ear (Figure 1). PTA revealed profound SNHL in the left ear (Figure 1). A 1-month follow-up PTA revealed additional hearing loss in the right ear without improvement of the left SNHL (Figure 1). At the 1-year follow-up PTA, there was improvement of hearing loss in both ears, particularly in the right ear (Figure 1). During a 3-year follow-up period, he remained symptom-free despite the persistence of left SNHL (Figure 1).
(A) Computed tomography images of the temporal bone demonstrate bilateral widening of the vestibules with an abnormally small bony island of lateral semicircular canals (black arrows) and soft tissue densities in the middle ear, and decreased mastoid air cells. (B,C) Axial three-dimensional fluid-attenuated inversion recovery images obtained 4 h after intravenous administration of gadolinium reveal cochlear endolymphatic hydrops (EH) with dilation of the scala media in the left ear (C, white arrows), but no EH in the right ear (B).
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F2
Computed tomography (CT) imaging of the temporal bone revealed bilateral widening of the vestibules, soft tissue densities in the middle ear, and decreased mastoid air cells (Figure 2A). Axial 3D-FLAIR revealed cochlear EH with dilation of the scala media in the left ear (Figures 2B,C), but no cochlear enhancement or vestibular EH.