Inner ear and the balance between thrombosis and bleeding

Abstract

Introduction

This paper reports a case of spontaneous intralabyrinthine haemorrhage as a cause of sudden sensorineural hearing loss, and discussed the implications that abnormal intralabyrinthine findings may have in the treatment of these cases.

Case report

A 56-year-old woman with history of anticoagulants intake, was diagnosed with profound right-sided sensorineural hearing loss. Brain/inner ear Magnetic Resonance Imaging showed right-side labyrinthine haemorrhage. Blood tests were within the appropriate range. The patient began treatment with corticosteroids, and on the fifth day of treatment, because there was no improvement, suspend anticoagulation, for being possible and safe. The patient also started hyperbaric oxygen therapy, with mild improvement in hearing function.

Discussion

In fact, there is no consensus in literature that specifies the best management of a proven intralabyrinthine haemorrhage. Further studies with representative samples are needed in order to understand whether the suspension of anticoagulants, when possible, may have real prognostic implications, as noted in the reported case. Our case represents one of the few reported in the literature that shows the possible results of the suspension of oral anticoagulation in the recovery of the audiological and vestibular consequences of intra-labyrinthine haemorrhage.

Keywords:

• Sensorineural hearing loss
• sudden hearing loss
• inner ear
• magnetic resonance imaging

Disclosure statement

This Declaration of Interest takes effect upon acceptance of the Submission entitled ‘Inner ear and the balance between thrombosis and bleeding’ for publication.

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no financial support for this work that could have influenced its outcome.

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The authors also declare authorization by Ethics Committee to carry out this study and they have written consent signed by the patient for the use of clinical information, scan images and other complementary diagnosis exams, as well as its publication and disclosure in scientific journals.

Best regards,

Joana Costa