Sensorineural Hearing Loss in Leukemia: A Case Report Showing Intravascular Coagulation in the Cochlea and Vestibular Labyrinth

Ann Otol Rhinol Laryngol. 2019 Aug;128(8):689-695. doi: 10.1177/0003489419838288. Epub 2019 Mar 27.

Abstract

Introduction: Sensorineural hearing loss frequently has been described in patients with leukemia, and in fact, hearing loss may be the presenting symptom of this disease. However, the pathogenesis of sensorineural hearing loss in leukemia is not well understood.

Objective: To describe the temporal bone histopathology in 1 patient with leukemia and sensorineural hearing loss.

Methods: The histopathology of the temporal bones of 1 patient with chronic myelomonocytic leukemia who suffered well-documented bilateral sequential profound sensorineural hearing loss 4 months before death was investigated using light microscopy.

Result: There was evidence of ischemic necrosis of the neuroepithelium and intravascular fibrin micro-thrombi suggestive of intravascular coagulation in the cochlea and vestibular labyrinth.

Conclusion: Intravascular coagulation may be a contributing factor in the commonly reported finding of hemorrhage in the cochlea in leukemia and may play a role in the pathogenesis of sensorineural loss in some cases of leukemia.

Keywords: histopathology; human; intravascular coagulation; leukemia; sensorineural hearing loss; temporal bone pathology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cochlea / pathology
  • Hearing Loss, Sensorineural / etiology*
  • Hearing Loss, Sensorineural / pathology
  • Humans
  • Leukemia, Myelomonocytic, Chronic / complications*
  • Leukemia, Myelomonocytic, Chronic / pathology*
  • Male
  • Temporal Bone / pathology
  • Vestibule, Labyrinth / pathology