A rare case of tophi presentation in bilateral ears of an elderly, postmenoupause patient

Introduction

Hypacusia can stem from various etiologies; however, hearing loss attributed to gouty tophiremains a rare occurrence. This case report represents first time that bilateral gouty tophie are causing hearing impairment.

Case presentation

This report presents a case study involving an 83-year-old Caucasian female patient who presented with symptoms of hypacusia, pruritus, and a sensation of pressure in her right ear. A computed tomography scan revealed the presence of non-homogeneous calcified structures in both ears. Following a comprehensive assessment that included pure-tone audiometry and a thorough evaluation of the patient's clinical complaints, a tympanoplasty procedure was conducted initially on the right ear.

Pathological analysis revealed the presence of gouty tophi. Subsequent to the surgical removal of the tophus, a notable improvement in the patient's hearing function was observed. Four months later, a similar surgical intervention was performed on the contralateral ear, achieving a similar positive outcome.

Conclusion

Gout tophus in both of ear is a rare but possible cause for hypacusia, even if there is no pre-existing diagnosis of systemic gout disease. We report a case of gout tophi, which is the rare cause of hearing loss in both ears.

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