Background <p>Subclavian steal syndrome (SSS) seldom manifests with isolated otologic symptoms, and sudden sensorineural hearing loss (SSNHL) as the initial presentation is infrequent. This case underscores the critical—though often overlooked—relationship between vertebrobasilar hemodynamics and inner ear perfusion, broadening the differential diagnosis for acute audiovestibular complaints.</p> Case presentation <p>A 51-year-old female presented with sudden-onset left-sided sensorineural hearing loss, recurrent vertigo, and ischemic manifestations in the left upper extremity. Audiometric assessment confirmed severe acute sensorineural hearing loss, and vestibular evaluation indicated labyrinthine impairment. Doppler ultrasonography revealed retrograde flow in the left vertebral artery. Subsequent computed tomographic angiography and digital subtraction angiography identified critical stenosis of the proximal left subclavian artery, accompanied by a classic subclavian steal phenomenon. The patient underwent percutaneous transluminal angioplasty and stent placement.</p> Results <p>Following vascular reconstruction surgery, the patient’s symptoms of dizziness and upper-limb ischemia improved significantly. Nevertheless, hearing recovery remained limited. Subsequently, due to economic factors, the patient did not undergo further diagnostic or therapeutic measures.</p> Conclusion <p>This case demonstrates that SSS can present initially with sudden hearing loss and vertigo, underscoring the importance of otolaryngologists maintaining a high index of suspicion for vascular causes in atypical SSNHL. Early vascular imaging and prompt restoration of blood flow are critical to avoid permanent cochlear injury. This report enhances clinical recognition of rare vascular origins of inner ear ischemia and underscores the pathophysiological dissociation between vestibular recovery and auditory outcomes.</p>

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Case report and literature review of subclavian steal syndrome presenting with otologic symptoms as the initial clinical manifestation

  • Qian Yu,
  • Yuedong Zhang,
  • Linlin Wang,
  • Xin Zhou

摘要

Background

Subclavian steal syndrome (SSS) seldom manifests with isolated otologic symptoms, and sudden sensorineural hearing loss (SSNHL) as the initial presentation is infrequent. This case underscores the critical—though often overlooked—relationship between vertebrobasilar hemodynamics and inner ear perfusion, broadening the differential diagnosis for acute audiovestibular complaints.

Case presentation

A 51-year-old female presented with sudden-onset left-sided sensorineural hearing loss, recurrent vertigo, and ischemic manifestations in the left upper extremity. Audiometric assessment confirmed severe acute sensorineural hearing loss, and vestibular evaluation indicated labyrinthine impairment. Doppler ultrasonography revealed retrograde flow in the left vertebral artery. Subsequent computed tomographic angiography and digital subtraction angiography identified critical stenosis of the proximal left subclavian artery, accompanied by a classic subclavian steal phenomenon. The patient underwent percutaneous transluminal angioplasty and stent placement.

Results

Following vascular reconstruction surgery, the patient’s symptoms of dizziness and upper-limb ischemia improved significantly. Nevertheless, hearing recovery remained limited. Subsequently, due to economic factors, the patient did not undergo further diagnostic or therapeutic measures.

Conclusion

This case demonstrates that SSS can present initially with sudden hearing loss and vertigo, underscoring the importance of otolaryngologists maintaining a high index of suspicion for vascular causes in atypical SSNHL. Early vascular imaging and prompt restoration of blood flow are critical to avoid permanent cochlear injury. This report enhances clinical recognition of rare vascular origins of inner ear ischemia and underscores the pathophysiological dissociation between vestibular recovery and auditory outcomes.