Malhotra Raj, Schmitt Barrie, Tyler Ken, Agrawal Yuri
Department of Otolaryngology - Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA.
Department of Neurology University of Colorado School of Medicine Aurora Colorado USA.
Laryngoscope Investig Otolaryngol. 2025 Jul 16;10(4):e70206. doi: 10.1002/lio2.70206. eCollection 2025 Aug.
Sudden sensorineural hearing loss (SSNHL) is a frequently encountered condition that is often idiopathic but may be precipitated by infection. Neuroinvasive disease resulting from West Nile virus (WNV) is a rare cause of SSNHL, typically affecting immunocompromised patients and generally associated with minimal hearing recovery. We present a case of an immunocompetent woman who was diagnosed with SSNHL in the setting of a WNV infection and showed significant hearing improvement.
Case report and literature review.
A 55-year-old immunocompetent female presented to our Otolaryngology office after several visits to the emergency department for worsening disequilibrium and new onset bilateral hearing loss. An audiogram demonstrated bilateral SNHL. After a thorough inpatient evaluation for hematologic, oncologic, immunologic, and infectious etiologies, CSF and serum IgG and IgM antibodies to WNV were elevated. The patient was managed conservatively and, at follow-up, endorsed significant hearing improvement that was reflected on her repeat audiogram.
SSNHL in patients with neuroinvasive WNV is extremely rare, with only a small number of previously reported cases. WNV should be considered as a cause of SSNHL in the US, especially during the late summer and fall months. Patients should be counseled on the variable prognosis of the hearing loss, and early discussions regarding cochlear implantation should be pursued for patients without significant recovery of profound hearing loss. : IV.
突发性感音神经性听力损失（SSNHL）是一种常见病症，通常病因不明，但可能由感染引发。西尼罗河病毒（WNV）导致的神经侵袭性疾病是SSNHL的罕见病因，通常影响免疫功能低下的患者，且听力恢复通常较差。我们报告一例免疫功能正常的女性病例，该患者在WNV感染的情况下被诊断为SSNHL，并显示出显著的听力改善。
病例报告及文献综述。
一名55岁免疫功能正常的女性因平衡失调加重和新发双侧听力损失多次前往急诊科就诊后，前来我们的耳鼻喉科门诊。听力图显示双侧感音神经性听力损失。在对血液学、肿瘤学、免疫学和感染性病因进行全面的住院评估后，脑脊液及血清中WNV的IgG和IgM抗体升高。该患者接受了保守治疗，随访时，患者称听力有显著改善，这在她的复查听力图中得到了体现。
神经侵袭性WNV患者出现SSNHL极为罕见，此前仅有少数病例报道。在美国，WNV应被视为SSNHL的一个病因，尤其是在夏末和秋季。应告知患者听力损失的预后存在差异，对于重度听力损失未显著恢复的患者，应尽早讨论人工耳蜗植入问题。
