The Journal of Laryngology and Otology May 1979. Vol. 93. pp. 507-511.
Complete remission of a monosymptomatic unilateral sensorineural low-frequency hearing loss in a child By AGNETE PARVING
Introduction FLUCTUANT low-frequency hearing loss as part of Meniere's disease has been reported previously (S0rensen, 1959; Harrison, 1962; Parving, 1976). Recently we examined a child with a monosymptomatic unilateral sensorineural lowfrequency hearing loss that slowly became normal. We thought it to be of interest to report this case. Case history A girl, born in 1968, was admitted for audiological examination due to right-sided hearing loss found by school-screening audiometry in 1974. No familial disposition could be found. Pregnancy, delivery, neonatal period, psycho-motor and language development were normal. No story of head injuries. By thorough questioning no complaints of periodical dizziness, tinnitus, headache, nausea or vomiting had ever been present. Her mother, a nurse, had never noticed any autonomic symptoms in the child. Otoscopy was normal. Pure tone audiometry revealed a rising right-sided sensorineural hearing loss in the low frequency area of 45 db. HL. (Fig. 1). The left ear was normal. Bing's test was positive. Middle ear pressure was normal. Stapedial reflexes elicited by contralateral stimulation were present with no sign of recruitment. No caloric testing or X-ray tomography could be performed. In yearly controls the right-sided hearing ability improved. In June 1978 the hearing was normal in the low-frequency area, but had deteriorated in the high frequency area (see Fig. 1). There was still no complaint of dizziness, tinnitus or any autonomic symptoms. In order to find some sign of an hereditary pattern, the parents had performed both pure-tone audiometry and Bekesy-audiometry (Anderson and Wedenberg, 1968; Parving, 1978). No sign of heredity was found in any of these examinations. Her two siblings had normal school-screening audiograms. Discussion On the basis of the repeated audiological examinations it may be concluded that the patient had a monosymptomatic unilateral low-frequency hearing loss, which became normal over a period of four years. Such a type of hearing loss has to our knowledge never previously been reported. As mentioned, fluctuant low-frequency hearing loss in children has been \ described. However, in these patients the hearing loss has been part of the classical triad of Meniere's disease: hearing loss, tinnitus and dizziness i(S0rensen, 1959; Harrison, 1962; Parving, 1976). This patient had no complaints 507
508
A. PARVING
DATE 250974 1 5 250
20-
500
1000
2000
8000 Hz
>
/
•
•
*
-
\
509
CLINICAL RECORDS
20-
III
DATE 100976 250 125
500
>>
40-
60-
80"•-
-*•
dBHL
DATE 090877 125 2 0 5 DO 1
20-
IV
40-
60-
80-
00dBHL
)
1000
20,00
>——L
i
4000
8000 i
Complete remission of a monosymptomatic unilateral sensorineural low-frequency hearing loss in a child By AGNETE PARVING
Introduction FLUCTUANT low-frequency hearing loss as part of Meniere's disease has been reported previously (S0rensen, 1959; Harrison, 1962; Parving, 1976). Recently we examined a child with a monosymptomatic unilateral sensorineural lowfrequency hearing loss that slowly became normal. We thought it to be of interest to report this case. Case history A girl, born in 1968, was admitted for audiological examination due to right-sided hearing loss found by school-screening audiometry in 1974. No familial disposition could be found. Pregnancy, delivery, neonatal period, psycho-motor and language development were normal. No story of head injuries. By thorough questioning no complaints of periodical dizziness, tinnitus, headache, nausea or vomiting had ever been present. Her mother, a nurse, had never noticed any autonomic symptoms in the child. Otoscopy was normal. Pure tone audiometry revealed a rising right-sided sensorineural hearing loss in the low frequency area of 45 db. HL. (Fig. 1). The left ear was normal. Bing's test was positive. Middle ear pressure was normal. Stapedial reflexes elicited by contralateral stimulation were present with no sign of recruitment. No caloric testing or X-ray tomography could be performed. In yearly controls the right-sided hearing ability improved. In June 1978 the hearing was normal in the low-frequency area, but had deteriorated in the high frequency area (see Fig. 1). There was still no complaint of dizziness, tinnitus or any autonomic symptoms. In order to find some sign of an hereditary pattern, the parents had performed both pure-tone audiometry and Bekesy-audiometry (Anderson and Wedenberg, 1968; Parving, 1978). No sign of heredity was found in any of these examinations. Her two siblings had normal school-screening audiograms. Discussion On the basis of the repeated audiological examinations it may be concluded that the patient had a monosymptomatic unilateral low-frequency hearing loss, which became normal over a period of four years. Such a type of hearing loss has to our knowledge never previously been reported. As mentioned, fluctuant low-frequency hearing loss in children has been \ described. However, in these patients the hearing loss has been part of the classical triad of Meniere's disease: hearing loss, tinnitus and dizziness i(S0rensen, 1959; Harrison, 1962; Parving, 1976). This patient had no complaints 507
508
A. PARVING
DATE 250974 1 5 250
20-
500
1000
2000
8000 Hz
>
/
•
•
*
-
\
509
CLINICAL RECORDS
20-
III
DATE 100976 250 125
500
>>
40-
60-
80"•-
-*•
dBHL
DATE 090877 125 2 0 5 DO 1
20-
IV
40-
60-
80-
00dBHL
)
1000
20,00
>——L
i
4000
8000 i
