New onset tinnitus in the absence of hearing changes following COVID-19 infection.

BACKGROUND: A variety of neurosensory symptoms including tinnitus have been associated with COVID-19 infection. While most cases of tinnitus are associated with hearing loss, here we report a case of severe tinnitus following COVID-19 infection with normal thresholds through 8000 Hz. CASE REPORT: A 49-year-old male presented with new onset severe tinnitus following COVID-19 infection. Tinnitus was bilateral, constant and nonpulsatile. Audiometric evaluation revealed normal threshold through 8000 Hz, with mild hearing loss at 16,000 Hz. Conservative measures including masking strategies failed to mitigate symptoms. A trial of gabapentin 300 mg twice per day improved tinnitus with no notable side effects. CONCLUSION: This patient may represent a subpopulation of patients who suffer from severe tinnitus following COVID-19 infection in the setting of largely normal hearing. The pathophysiology may be distinct from the more common hearing loss associated tinnitus and perhaps neuromodulators may play a larger role in mitigating tinnitus in this patient subset.

Otolaryngological symptoms in COVID-19.

PURPOSE: The aim of this study was to evaluate the frequency of various otolaryngological symptoms in patients with COVID-19 with regard to age, gender and pneumonia-related thorax CT characteristics. METHODS: This is a retrospective study conducted between March 25, 2020 and April 25, 2020. The anamnesis and medical files of 155 patients who applied to our outpatient COVID-19 clinic were evaluated. Patients with positive PCR tests for COVID-19 who were aged between 18-72 years were divided into groups according to the presence of otolaryngological symptoms. The differences between the two groups were examined. RESULTS: Of the 155 patients, 89 (57.4%) had otolaryngological symptoms. The mean age of the patients was 36.3 ± 8.1 years. Ninety-one (58.7%) patients were female, and 64 (42.2%) were male. Fifty-eight (37.4%) patients had received a clinical diagnosis of viral pneumonia with ground glass findings in tomography. The frequency of otolaryngological symptoms was higher in females than males (p: 0.029). The otolaryngological symptoms were also observed to be more frequent in the 18-30 age group (p: 0.013) compared to other age groups. CONCLUSIONS: Tinnitus, gingivitis, sudden hearing loss, Bell's palsy, and hoarseness can be seen in COVID-19, albeit rarely. Revealing the otolaryngological symptoms of COVID-19, and obtaining more information about the extent of disease will be useful in managing patients and their complaints associated with otolaryngology.

Does coronavirus affect the audio-vestibular system? A rapid systematic review.

Objective: This rapid systematic review investigated audio-vestibular symptoms associated with coronavirus.Design: The protocol for the rapid review was registered in the International Prospective Register of Systematic Reviews and the review methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using the National Institute of Heath quality assessment tools.Study sample: After rejecting more than 2300 records, there were five case reports and two cross-sectional studies that met the inclusion criteria.Results: No records of audio-vestibular symptoms were reported with the earlier types of coronavirus (i.e. severe acute respiratory syndrome [SARS] and Middle East respiratory syndrome [MERS]). Reports of hearing loss, tinnitus, and vertigo have rarely been reported in individuals who tested positive for the SARS-CoV-2.Conclusion: Reports of audio-vestibular symptoms in confirmed COVID-19 cases are few, with mostly minor symptoms, and the studies are of poor quality. Emphasis over time is likely to shift from life-threatening concerns to longer-term health-related consequences such as audio-vestibular dysfunction. High-quality studies are needed to investigate the acute effects of COVID-19, as well as for understanding long-term risks, on the audio-vestibular system. Review registration: Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42020184932).

[A case of herpetic facial paralysis in which cochleovestibular symptoms outweigh facial nerve symptoms]. / Kokleovestibüler semptomlarin ön planda oldugu herpetik fasyal paralizi: Olgu sunumu.

A 42-year-old man presented with sensorineural hearing loss of acute onset, tinnitus, and vertigo. Physical examination revealed slight asymmetry in facial nerve functions and spontaneous nystagmus. Magnetic resonance imaging of the internal acoustic canal showed contrast enhancement consistent with edema-inflammation, being notable and diffuse in the seventh and eighth cranial nerve complex, and minimal in the cochlea. Non-hydropic cochleovestibular syndrome was considered and the patient was treated with antiviral and corticosteroid medications. A week later, facial paralysis improved and the acute hearing loss reversed. On the twelfth day of presentation, he had no complaints other than mild imbalance on abrupt changes in movement. In this type of herpetic facial paralysis in which cochleovestibular symptoms outweigh facial nerve symptoms, it might be argued that varicella zoster virus reactivation occurs in the spiral and/or vestibular ganglion.

Tinnitus and Coxsackie B infections: a case series.

Tinnitus is a frequent and often debilitating condition. There is consensus in the scientific community that there exist various forms of tinnitus, which differ in their pathogenesis. Here we report a series of five cases where the onset of tinnitus was associated with viral infections. In all five patients elevated antibodies against Coxsackie B have been detected. This observation suggests that Coxsackie B Virus infections might be involved in the development of some cases of tinnitus and indicate that further systematic investigations are warranted.

Enteroviruses and sudden deafness.

A young, healthy man presented with sudden severe sensorineural hearing loss and tinnitus. The results of the workup and neuroimaging were normal, as were the auditory brain stem responses. Methylprednisolone pulse therapy was associated with significant hearing improvement within 10 days. A history of a short self-limited febrile illness preceding admission (with headache, photophobia, myalgia and fatigue), a raised serum C-reactive protein level and transient leukopenia suggested an infectious cause. Lumbar puncture revealed a mononuclear pleocytosis of the cerebrospinal fluid, with negative cultures but positive polymerase chain reaction test results for enterovirus, which was later cultured from the patient's stool. The patient's wife and baby had had a similar febrile illness without hearing loss 10 days earlier, and an outbreak of enterovirus meningitis was identified in the area, which was associated with familial clustering and echovirus serotype 4 infection. The varied causes of sudden sensorineural hearing loss, which should include enterovirus, are reviewed here.