Hearing loss of acquired syphilis: diagnosis confirmed by incudectomy

The Laryngoscope
J B Nadol

Abstract

Syphilis, both congenital and acquired, may cause sensori-neural hearing loss. Congenital syphilis presents in two forms: early (infantile), and late (tardive). Acquired syphilis, both secondary and tertiary, may cause deafness. The clinical course of the acquired and congenital forms are similar. Sensori-neural hearing loss with low discrimination scores may affect both ears simultaneously or sequentially, and vestibular complaints are common. A clinical diagnosis can be made on the basis of history, the presence of other stigmata of syphilis, and serological tests, including the FTA-ABS. The histopathology of acquired and congenital forms is indistinguishable and is essentially twofold: first, syphilis may cause a miningo-neurolabyrinthitis with round cell infiltration of the labyrinth and VIIIth nerve as the predominant lesion in early congenital syphilis and the acute meningitides of secondary and tertiary acquired syphilis. Second, syphilis may cause a perivascular round cell osteitis of the temporal bone with secondary involvement of the membranous labyrinth in both late congenital and acquired late latent or tertiary syphilis. Endolymphatic hydrops may be seen in both the congenital and acquired forms. A case of bilatera...Continue Reading

Citations

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