A thirty eight year old lady presented to Asian ent care centre on 6-1-2010 with a history of sudden hearing loss in the right ear since 4 days. The clinical history revealed that the patient woke up on 2-1-2010 and realised numb sensation on the right ear and tinnitus . she neglected for 2 days and on 4 –1-2010 morning, she realised that there was a complete loss of hearing in right ear. There was no associated dizziness, vertigo, nausea, or vomiting. There was no history of any illnessess or hypertension or diabetes. Hearing was subjectively reported to be normal bilaterally prior to this episode. There was no significant past medical history . she consulted a family physician and was given medication for 2 days. And later was referred to ENT surgeon.on 6-1-2010 .
Physical examination was unremarkable. Initial audiogram showed a pure tone average of 76 dB on the Right ear and 15dB on the left ear Tympanograms were Type A bilaterally. OAE were absent bilaterally.
The patient was started on a Tab.Acyclovir along withTab. prednisone treatment from 70 mg for 5 days.
On 9-01-2010, the PTA revealed 73 dB on right ear and 15dB on left ear.
The tapering of prednisone was done to 60mg on12-1-2010.
She also experienced subjective improvement , and repeat audiogram on day 12-1-2010 showed pure tone average of 35 on the right and 21dB on the left ear. On 16-1-2010, the repeat audiogram showed a signifant improvement in the hearing threshold. The pta was 25 dB on the right and 18 dB on the left ear.
The prednisone was further tapered to 40mg, 30mg and 10 mg and was asked to stop the medicines on21-1-2010 At follow-up on 22-1-2010, the patient reported subjective return of normal hearing .she was advised follow up visits