Sudden Sensorineural Hearing Loss Following the Second Dose of COVID-19 Vaccine

Abstract

Sudden sensorineural hearing loss (SSHL) is a common otolaryngology emergency that significantly affects the patient’s quality of life. Although in most cases its etiology remains unknown (idiopathic SSHL), viral infections and vascular compromise constitute the most widely accepted etiopathogenic mechanisms. Specifically, occlusion of the internal auditory artery has been reported in cases of sudden deafness. Thrombotic events following the Oxford-AstraZeneca COVID-19 vaccine are rare. There have been reports of SSHL following immunization with Pfizer and Moderna COVID-19 vaccine; however, no etiologic relationship has been established between the two entities yet. We present a unique case of SSHL following the second dose of the Oxford-AstraZeneca COVID-19 vaccine. A 61-year-old female was referred to our department with a four-day history of the right-sided sense of fulness combined with almost complete hearing loss that had started two days after the second dose of Oxford-AstraZeneca COVID-19 vaccine. Pure tone audiometry showed profound right-sided sensorineural hearing loss. Magnetic resonance imaging of the brain and internal auditory canal and magnetic resonance angiography were both normal. The combination of glucocorticoids and acetylsalicylic acid leads to almost full recovery 15 days after deafness. The COVID-19 era is full of new challenges and clinical dilemmas. In our case, the addition of acetylosalicid acid to the patient’s initial treatment may have contributed to the hearing restoration; however, this fact will remain a hypothesis.

Acute Vertigo After COVID-19 Vaccination: Case Series and Literature Review

“…Indeed, it is worth citing a research letter from Formeister from Johns Hopkins University School of Medicine, Baltimore, which reported that the incidence of SSNHL occurring after COVID-19 vaccination does not exceed that of the general population, and may be lower ( 18 ). Although there is no direct evidence of the association between vaccination and SSNHL, some cases of SSNHL after COVID-19 vaccination have been recently reported ( 19 , 20 ).…”

Tinnitus, Sudden Sensorineural Hearing Loss, and Vestibular Neuritis As Complications of the Astra Zeneca COVID-19 Vaccine

“…Many authors have considered a possible link between COVID-19 infection and SSHL [2,[6][7][8][9][10]; however, as far as the author knows this is the first case series considering the possible association between a COVID-19 vaccine and inner ear damage, which could indeed have pathophysiology similar to that of the cases of SSHN secondary to COVID-19 infection. We display the audiometries of cases 1 and 5 since we believe them to be the most representative of the situation described by Tseng et al [12] (case 1) and the one described by Tsetsos et al [11] (case 5). Even if two cases presented here did not clearly show the traditional full criteria for SSHL, the presentation was very similar to a traditional SSHL and both were treated as such by using steroids similar to what was described by Tseng et al [12], with most cases having the resolution of the symptoms around the day 3 of management.…”

“…Several previous reports have mentioned the possible link between COVID-19 infection and inner ear damage [2,[6][7][8][9][10]; however to the authors´ very best knowledge this is the first case series considering the possible association between AZCV (or any COVID-19 vaccine) and inner ear damage, and so far only two previous isolated single case reports of auditory symptoms related to the AZCV have been described, including one report of SSHL itself [11], and one report of tinnitus presumably associated to cochleopathy secondary to the vaccine [12]. To our best knowledge, this is the first report of a patient with vestibular symptoms related to the AZCV.…”

Audiovestibular Disorders after COVID-19 Vaccine: Is There an Association?

“…Tsetsos et al [ 22 ] in August 2021, reported a SSNHL, without tinnitus and vertigo, two days after the second dose of the AstraZeneca COVID-19 vaccine. The patient was a 61-year-old female with a history of hypertension, dyslipidemia, and thyroiditis, under pharmacological treatment long-term.…”

“…Among the selected papers, seven were related to SSNHL following COVID-19 immunization, mainly with associated tinnitus [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”