Bilateral cochlear fibrosis complicating chronic myeloid leukemia: A CARE case report - 08/08/24

Doi : 10.1016/j.anorl.2024.07.003

G. Lahlou ^a,^b,⁎ , H. Daoudi ^a,^b, C. Djian ^c, I. Mosnier ^a,^b
^a Département d’oto-rhino-laryngologie, groupe hospitalo-universitaire Pitié-Salpêtrière, AP–HP, Sorbonne université, Paris, France
^b Équipe TGTD (Technologies and Gene Therapy for Deafness), Institut de l’audition–Institut Pasteur, Paris, France
^c Département d’oto-rhino-laryngologie, hôpital Lariboisière, AP–HP, université Paris Cité, Paris, France

^⁎Corresponding author. Service d’ORL et de chirurgie cervico-faciale, groupe hospitalier Pitié Salpétrière, AP–HP, Sorbonne Université, 47, boulevard de l’Hôpital, 75013 Paris, France.Service d’ORL et de chirurgie cervico-faciale, groupe hospitalier Pitié Salpétrière, AP–HP, Sorbonne Université47, boulevard de l’HôpitalParis75013France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 08 August 2024

Abstract

Purpose

We report the second case of bilateral sudden sensorineural hearing loss with intracochlear fibrosis due to chronic myeloid leukemia.

Case report

A 44-year-old man presented to the emergency department with rapidly progressive bilateral hearing loss, tinnitus and vertigo, associated with dyspnea. Chronic myeloid leukemia complicated by pulmonary and cochleovestibular leukostasis was diagnosed, and cytoreductive treatment was started. Despite this treatment, bilateral total hearing loss and complete vestibular deficit persisted. MRI showed bilateral labyrinthitis, and emergency cochlear implantation was indicated. During surgery, inflammatory intracochlear tissue made electrode array insertion possible only against resistance. One year after implantation, there was significant improvement in speech recognition and communication scores.

Conclusion

In case of sudden sensorineural hearing loss induced by chronic myeloid leukemia, treatment should be as fast as possible, with prompt cochlear implantation in case of definitive profound hearing loss, because of the risk of cochlear fibrosis and ossification.

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Keywords : Sudden sensorineural hearing loss, Chronic myeloid leukemia, Leukostasis syndrome, Cochlear implantation