Auditory Performance in Recovered SARS-COV-2 Patients.

OBJECTIVE: While COVID-19 symptoms impact rhinology (anosmia) and laryngology (airways), two major disciplines of the otolaryngology armamentarium, the virus has seemed to spare the auditory system. A recent study, however, reported changes in otoacoustic emission (OAE) signals measured in SARS-COV-2 positive patients. We sought to assess the effect of COVID-19 infection on auditory performance in a cohort of recovered SARS-COV-2 patients and controls. To avoid a potential bias of previous audiological dysfunction not related to SARS-COV-2 infection, the study encompasses patients with normal auditory history. We hypothesized that if SARS-COV-2 infection predisposes to hearing loss, we would observe subtle and early audiometric deficits in our cohort in the form of subclinical auditory changes. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary referral center. PATIENTS: The Institutional Review Board approved the study and we recruited participants who had been positive for SARS-COV-2 infection, according to an Reverse Transcription Polymerase Chain Reaction (RT-PCR) test on two nasopharyngeal swabs. The patients included in this study were asymptomatic for the SARS-COV-2 infection and were evaluated following recovery, confirmed by repeated swab testing. The control group comprised healthy individuals matched for age and sex, and with a normal auditory and otologic history. INTERVENTIONS: The eligibility to participate in this study included a normal audiogram, no previous auditory symptoms, normal otoscopy examination with an intact tympanic membrane, and bilateral tympanometry type A. None of our volunteers reported any new auditory symptoms following SARS-COV-2 infection. Ototacoustic emissions (OAE) and auditory brainstem response (ABR) measurements were used to evaluate the auditory function. MAIN OUTCOME MEASURES: OAE and ABR measurements. RESULTS: We have found no significant differences between recovered asymptomatic SARS-COV-2 patients and controls in any of transitory evoked otoacoustic emission (TEOAE), distortion product otoacoustic emissions (DPOAE), or ABR responses. CONCLUSIONS: There is no cochlear dysfunction represented by ABR, TEOAE, and DPOAE responses in recovered COVID-19 asymptomatic patients. Retrocochlear function was also preserved as evident by the ABR responses. A long-term evaluation of a larger cohort of SARS-COV-2 patients will help to identify a possible contribution of SARS-COV-2 infection to recently published anecdotal auditory symptoms associated with COVID-19.

Prevalence and characteristics of hearing loss in patients diagnosed with Bell's Palsy.

OBJECTIVES: To assess the incidence of hearing loss in patients diagnosed with Bell's palsy (BP) and to characterize its clinical features. DESIGN: Patients with BP who underwent audiometry testing in our institute were included. Bone hearing level differences between the ipsilateral and the contralateral ears to the palsied side were calculated for 6 frequencies: 250, 500, 1000, 2000, 4000 and 8000 Hz. Subjects with interaural differences higher than 5 dB in at least one frequency were considered as having ipsilateral unilateral sensorineural hearing loss (uSNHL). RESULTS: Twenty-four cases of subjects with BP who underwent hearing exams were included. Thirteen were women (54.2%) and the average age was 37.4 years. Nine patients (37.5%) were found to have an ipsilateral uSNHL (group A); a maximal interaural difference of 5dB in all the frequencies was found in 15 subjects (62.5%, group B). The interaural maximal difference was found to be significantly higher between the two groups (p = 0.0295, n = 24). Group A showed a mean of maximal difference of 18.9 ± 9.3 dB compared to 3 ± 2.5 dB in group B (p < 0.001). A higher difference was calculated in the higher frequencies (2000, 4000, 8000 Hz) (R-spearman = 0.226, p = 0.003). CONCLUSIONS: We have demonstrated significant ipsilateral uSNHL in our cohort of patients diagnosed with BP. We, therefore, believe that all patients who are diagnosed with BP should undergo an audiometry examination. Further prospective studies with larger cohorts are necessary to support our observations.