Halmagyi GM, Parker GD, Chen L, Welgampola MS, Watson JDG, Barnett MH, Todd MJ, El-Wahsh S, Rose V, Stoodley MA, Brennan JW. Progressive loss of hearing and balance in superficial siderosis due to occult spinal dural defects.
Eur Arch Otorhinolaryngol 2023;
280:633-641. [PMID:
35841407 PMCID:
PMC9849153 DOI:
10.1007/s00405-022-07523-3]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/20/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE
Superficial siderosis, a progressive, debilitating, neurological disease, often presents with bilateral impairment of auditory and vestibular function. We highlight that superficial siderosis is often due to a repairable spinal dural defect of the type that can also cause spontaneous intracranial hypotension.
METHODS
Retrospective chart review of five patients presenting with moderate to severe, progressive bilateral sensorineural hearing loss as well as vestibular loss. All patients had developed superficial siderosis from spinal dural defects: three after trauma, one after spinal surgery and one from a thoracic discogenic microspur.
RESULTS
The diagnosis was made late in all five patients; despite surgical repair in four, hearing and vestibular loss failed to improve.
CONCLUSIONS
In patients presenting with progressive bilateral sensorineural hearing loss, superficial siderosis should be considered as a possible cause. If these patients also have bilateral vestibular loss, cerebellar impairment and anosmia, then the diagnosis is likely and the inevitable disease progress might be halted by finding and repairing the spinal dural defect.
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