Surdez Súbita na Criança: Caso clínico ; Sudden Sensorineural Hearing Loss in Children - a case report

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina ; IntroductionDeafness can be classified into two subtypes - conductive and sensorineural, whose distinction is an essential step in the course of etiological investigation. Sudden sensorineural hearing loss is defined as a hearing loss of 30 dBs or more in at least 3 contiguous audiometric frequencies, within a period of 72 hours or less. In pediatric age, this condition is considered uncommon, corresponding to 6.6% of all cases of sudden sensorineural hearing loss. It can manifest as an isolated condition or be part of a systemic disease. It is called idiopathic when no other cause is identified. Data in medical literature about this pathology in pediatric age is scarce and many questions remain to be answered, namely the different clinical presentations, etiology, effectiveness of treatments and associated prognosis.Case ReportWe present the case of a 9-year-old female patient, who developed sudden tinnitus on the left ear and left temporoparietal headache, with associated vertigo, nausea and vomiting. Upon initial objective examination, no otoscopic or neurological abnormalities were identified, other than a nystagmus grade I with a fast component to the right. The following complementary diagnostic tests were performed: pure tone audiogram, tympanogram, otoacoustic emissions and cVEMPs, reavealing profound deafness in the left ear, a type A tympanogram and low amplitudes in the cVEMPs on the left at 105 dBs. In this context, treatment was initiated with corticosteroid therapy through a transtympanic tube, followed by 20 sessions of hyperbaric oxygen, without recovery of audiometric thresholds. Currently, the placement of a cochlear implant is being considered.ConclusionSudden sensorineural hearing loss in pediatrics is an unusual situation that can pose a challenge for clinicians, both in timely diagnosis and effective treatment. Therefore, a high degree of clinical suspicion is crucial in order to make a diagnosis as early ...