ABSTRACT
OBJECTIVE: To report a case of labyrinthine hemorrhage with a sudden sensorineural hearing loss and vertigo. This is a rare mechanism of inner ear damage, which may be considered in patients with anticoagulant therapy. MATERIAL AND METHODS: We report a case of sudden sensorineural hearing loss and vertigo in a 73-year-old male on anticoagulant therapy for arrhythmia. An audiovestibular and imaging work-up was performed. RESULTS: Audiometry showed a left profound hearing loss. Videonystagmography demonstrated a left labyrinthine deficit. Hemostasis assessment showed an INR at 7.5 MR imaging evidenced a high intralabyrinthine signal on T1-weighted images without gadolinium and on FLAIR T2-weighted images, suggesting labyrinthine hemorrhage. At clinical follow-up the vertigo regressed but the hearing function was not recovered. CONCLUSION: Labyrinthine hemorrhage should be evoked in the event of sudden sensorineural hearing loss in patients with anticoagulant therapy. MRI is a useful diagnostic tool in this case.
Subject(s)
Anticoagulants/adverse effects , Hemorrhage/chemically induced , Labyrinth Diseases/chemically induced , Aged , Ear, Inner/pathology , Hearing Loss, Sudden/etiology , Hemorrhage/diagnosis , Humans , Labyrinth Diseases/diagnosis , Magnetic Resonance Imaging , Male , Vertigo/etiologyABSTRACT
OBJECTIVE: To report a nasal leishmaniasis diagnosed by septal perforation biopsy. MATERIAL AND METHODS: We report a case of septal perforation with crusty rhinosinusitis and nasal vestibulitis in a 54-year-old woman with cirrhosis. RESULTS: Mucocartilaginous biopsy revealed a mucosal leishmaniasis. Biological and radiologic findings were normal. Clinical follow-up with anti-parasitical treatment showed a regression of the patient's muco-cutaneous lesion and regression of her hepatic insufficiency. CONCLUSION: Biopsy of septal perforation is a useful diagnostic tool, advocated for differentiate infectious, neoplasic and inflammatory pathology. Leishmaniasis may be evoked in rhinologic pathology.