Department of Otolaryngology, Command Hospital (CC), Lucknow, UP, IndiaIndia
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Thirty-four-years old male, soldier by occupation had complains of three episodes of loss of consciousness lasting for 3-4 seconds for last one year. There was no history of giddi-ness, ear discharge, aural fullness, autotoxin medication, tinnitus etc. His examination revealed bilateral normal tympanic membrane and tuning fork tests were suggestive of left sided Sensor Neural Hearing Loss (SNHL).
ISSN 2470-4059 http://dx.doi.org/10.17140/OTLOJ-2-124 Open Journal Letter to The Editor Loss of Consciousness: Can there be * *Corresponding author Unexpected Otolaryngology Etiology?
Arpit Saxena, MS (ENT) Department of Otolaryngology Command Hospital (CC) Lucknow, UP, India * Arpit Saxena, MS (ENT) ; V. R. Sinha, MS (ENT), DNB; D. K. Singh, MS (ENT) Tel. +91-9532306179 E-mail: arpitsaxenaexam@gmail.com Department of Otolaryngology, Command Hospital (CC), Lucknow, UP, India Volume 2 : Issue 4 Article Ref. #: 1000OTLOJ2124 I am honoured and enthusiastic to be a part of Otolaryngology-Open Access Journal. I will like to discuss a case of academic interest.
Article History th Received: August 12th, 2016 Thirty-four-years old male, soldier by occupation had complains of three episodes of th Accepted: August 24th, 2016 loss of consciousness lasting for 3-4 seconds for last one year. There was no history of giddi- th Published: August 24th, 2016 ness, ear discharge, aural fullness, autotoxin medication, tinnitus etc. His examination revealed bilateral normal tympanic membrane and tuning fork tests were suggestive of left sided Sensor Citation Neural Hearing Loss (SNHL). Patient was unaware of hearing loss. Fistula test was negative Saxena A, Sinha VR, Singh DK. Loss and caloric test demonstrated left canal paresis. Rest neurotological examination was normal. of consciousness: Can there be unex- Audiomertry presented left sided moderate severe SNHL. Cardiologist and neurologist evalua- pected otolaryngology etiology? Otolar- tion was normal. MRI brain was also normal.
yngol Open J. 2016; 2(4): 109-110. doi: 10.17140/OTLOJ-2-124 In view of left sided ear hearing loss and canal paresis on caloric test, high resolution CT temporal bone was performed and it clinched the diagnosis of left Superior Semicircular Canal Dehiscence (SSCD) (Figure 1). The patient was taken up for surgical closure of SSCD by middle cranial fossa approach. The defect was closed by fat and tissue glue. Presently, patient is asymptomatic for two years.
The true incidence of SSCD is unknown due its rare presentation. The etiology of this syndrome was localized to a dehiscence of the bone covering the superior semicircular canal. The abnormal communication between the superior semicircular canal and the brain can result in vertigo and oscillopsia induced by loud sounds (Tullio phenomenon), by changes in pressure in the ear canal that are transmitted to the middle ear (Hennebert sign), or by Valsalva 1-3 maneuvers.1-3 Our patient was not having any such presentation as described making it atypical. Copyright Our case of young adult soldier with episodes of loss of consciousness with unilateral SNHL is ©2016 Saxena A. This is an open being reported to emphasize on complete neurotological examination and thorough workup on access article distributed under the such patients as diseases can have unusual presentation. Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, CONFLICTS OF INTEREST distribution, and reproduction in any medium, provided the original The authors declare that they have no conflicts of interest. work is properly cited.
ISSN 2470-4059 http://dx.doi.org/10.17140/OTLOJ-2-124 Open Journal