Acute hearing loss due to intracochlear leukemic infiltration of CLL

Introduction Chronic lymphatic leukemia (CLL) is the most common form of leukemia. It is a low malignant B-cell lymphoma. Hearing loss can occur during the course of the disease. However, the manifestation described in this case as a solid intracochlear infiltrate is not yet reported.

Methods/results Clinical case report, literature research Case report In a 56-year-old patient, cochlear implant surgery was indicated on the right side for bilateral severe hearing loss. The patient suffered from sudden hearing loss on both sides within a short period of time 7 months prior. Despite therapy there was no full recovery. A CLL was known (Binet B, "watch and wait").

In the external CT and MRT imaging no pathologies in the area of the labyrinth and the cerebellopontile angle angle were described. On closer inspection, a discrete loss of the fluid signal of the right basal turn could be detected in the CISS sequence.

After opening the round window membrane, a tumor was seen intraoperatively which obstructed the tympanic scale. After dilatation of the round window niche, the tumor could be removed and the electrode was inserted. The postoperative measurement showed proper implant function.

The histological examination revealed a leukemic infiltrate of the known CLL.

Conclusion Sporadic otopathological case reports describe a rare CLL hearing loss after infiltration of the eardrum, auditory canal or bone marrow of the tegmen.

To our knowledge, the histologically confirmed intracochlear manifestation presented here has not yet been described in the literature.

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Publication History

Article published online:
10 June 2020