Sudden onset bilateral hearing loss after forehead osteoma removal associated with superior semicircular canal dehiscence.
Elliot Joseph Brown, Balint Viktor Lovasz, Leandros Vassiliou et al.
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Case in brief
A 52-year-old woman with no previous hearing impairment developed profound bilateral sensorineural hearing loss immediately after emergence from general anaesthesia for elective frontal bone osteoma excision. Hearing partially improved spontaneously over hours, followed by right-sided predominance and tinnitus. Imaging excluded ischaemia. Audiometry showed a transient bilateral noise-induced pattern, with persistent mild right high-frequency loss. Further investigation identified bilateral superior semicircular canal dehiscence (SSCD). The authors proposed that vibration from intraoperative chiselling was transmitted abnormally to the inner ear through a pre-existing third window.
What made this case unusual
The postoperative hearing loss occurred after non-otologic skull surgery in a patient with bilateral SSCD, suggesting a possible link between chiselling-related vibration and inner-ear injury through a third-window pathway.
Diagnostic / clinical pearl
Sudden hearing loss after skull surgery warrants evaluation for both ischaemic causes and inner-ear abnormalities; bilateral SSCD may provide a plausible route for abnormal transmission of operative vibration.
Why it matters
The authors note that asymptomatic SSCD may be relevant to perioperative risk counselling for procedures involving skull vibration.