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Sudden sensorineural hearing loss (SNHL) accounts
for 1% of all SNHL cases. It has been reported that
acoustic neuroma may be present up to 47.5% of
patients with sudden SNHL. A 55-year-old man presented
with sudden hearing loss in his left ear of 45-day
history. Audiologic and transient evoked otoacoustic
emission tests showed near-total hearing loss and
absence of emissions in the left ear, respectively.
Electronystagmography showed left canal paralysis
and lack of response to the Kobrak test. The interpeak
interval I-V latency and interaural amplitude differences
in wave V latency were prolonged in auditory brainstem
response. Computed tomography showed an increase
in the diameter of the left internal acoustic canal, and
magnetic resonance imaging (MRI) revealed an intracanalicular
mass, 3 mm in size, originating from the left
cochlear nerve. Another mass (18x17 mm) was detected
that filled the right pontocerebellar cistern, suggesting
a meningioma, but this was not thought to exert an
obvious shift effect contributing to the development of
left-sided hearing loss. Despite treatment with a
tapered course of fluocortolone for 18 days the
patient’s hearing level did not change. He was included
in a follow-up with MRI at six-month intervals.