Recurrent infection-induced hearing deterioration of a patient with inner ear– specific steroid-dependent sensorineural hearing loss

Recurrent infection-induced hearing deterioration of a patient with inner ear–specific steroid-dependent sensorineural hearing loss. Hearing levels of patients with the steroid-dependent sensorineural hearing loss (SDSNHL) show definite dependency on steroid administration, and long-term maintenance with steroids is essential for controlling hearing deterioration. Causes of hearing deterioration are not known in patients with SDSNHL who are taking steroids maintenance dose (≤10 mg of Prednisolone over a period of years). The mechanism is particularly enigmatic in SDSNHL without any autoimmune disease, namely inner ear–specific SDSNHL (IE-SDSNHL). Here, we present a case with IE-SDSNHL, whose 11-year clinical course suggests that systemic stress from infections—such as the common cold, lymphadenitis, pharyngitis, cystitis, dermatitis, and abscess formation in the leg—was the trigger for hearing deterioration. In addition, cessation of steroid administration by non-otolaryngologists might worsen the hearing deterioration. Based on the characteristics of our case, we discussed the hearing deterioration mechanism in IE-SDSNHL relating to the stress response theory of the cochlear lateral wall. We emphasized that all physicians (including otolaryngologists) should be informed of IE-SDSNHL to avoid irreversible hearing deterioration in IE-SDSNHL patients. Prevention of infection and avoiding acute reduction of Prednisolone are critical to maintaining hearing in SDSNHL patients.