case_images: PMC11813542_01
case_images: Pure-tone audiometry. The findings indicated left sensorineural hearing loss centered around 1 kHz.
case_images: cureus-0017-00000077338-i01.jpg
case_images: PMC11813542_01_cureus-0017-00000077338-i01.jpg
case_images: FIG1
case_images: At her first visit, pure-tone audiometry revealed air conduction five-frequency average hearing levels of 17.0 dB in the right ear and 36.0 dB in the left ear, showing sensorineural hearing loss centered at 1 kHz (Figure 1).
case_images: Distortion-product otoacoustic emissions (DPOAE). (a) Good response in the right ear; (b) Poor response at 1, 2, and 3 kHz in the left ear
case_images: cureus-0017-00000077338-i02.jpg
case_images: PMC11813542_01_cureus-0017-00000077338-i02.jpg
case_images: FIG2
case_images: Distortion-product otoacoustic emissions (DPOAE) revealed poor responses at certain frequencies (Figure 2).
case_images: Contrast-enhanced MRI. No obvious abnormal signals or contrast effects were observed in the internal auditory canal.
case_images: cureus-0017-00000077338-i03.jpg
case_images: PMC11813542_01_cureus-0017-00000077338-i03.jpg
case_images: FIG3
case_images: CSF fluorescent treponemal antibody absorption (FTA-ABS) and TPAb (Table 2). Contrast-enhanced MRI revealed no abnormal signals in the internal auditory canal (Figure 3).
case_images: Pure-tone audiometry. (a) Shortly before the start of treatment; compared with the initial hearing test, an increase in the hearing threshold of the left ear was observed. (b) One month after the start of treatment; a decrease in the low-frequency threshold was observed. (c) Two months after the start of treatment; A decrease in the high-frequency threshold was observed. No change was noted in the 1 kHz threshold.
case_images: cureus-0017-00000077338-i04.jpg
case_images: PMC11813542_01_cureus-0017-00000077338-i04.jpg
case_images: FIG4
case_images: Hearing tests performed immediately before treatment initiation revealed a further increase in the left hearing threshold (Figure 4a). After one month of treatment, an improvement in the hearing threshold at low frequencies in the left ear was observed, and her hearing loss and sensation of ear fullness resolved (Figure 4b). After two months of treatment, a decrease in the high-frequency hearing threshold in the left ear was noted, although the hearing level at 1 kHz remained unchanged (Figure 4c).