A CASE OF REVERSIBLE HEARING LOSS IN ASPIRIN OVERDOSAGE

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  • アスピリン大量摂取による可逆性薬剤性難聴の1例

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Most often drug-induced hearing loss is known to cause permanent damage, such as that caused by Aminoglycoside antibiotics and Platinum antitumor agent. We report the experience of a case of reversible hearing loss in a case of aspirin overdosage. A 58-year-old man visited our institution for hearing loss as the chief complaint after aspirin overdose （50 tablets, 330mg each）. Pure tone audiometry （PTA） showed bilateral symmetric sensorineural hearing loss of 45dB HL. Distortion product otoacoustic emissions （DPOAE） showed no response in both ears. He received adenosine triphosphate disodium and vitamin B12 and revisited the institution 4 days later. PTA were normalized to 15dB HL and he was diagnosed as acute sensorineural hearing loss caused by aspirin. Aspirin, which is acetylsalicylic acid, is a common pain reliever that can cause reversible hearing loss. The degree of hearing loss is known to be proportional to the plasma concentration of salicylate. It is reported that by ingesting a large amount of aspirin at one time, aspirin forms a clump in the stomach and it is absorbed slowly. Therefore, the current patient had an onset of hearing loss later than what may be expected. In addition, the plasma concentration of salicylate did not increase very much and the only symptom was hearing loss. It is necessary however to be careful because there is a report of the same amount of aspirin ingestion causing a severe condition which required dialysis. There are some reports of permanent hearing loss induced by aspirin. In cases which do not recover, early treatment with steroid is necessary. There is a report of such an overdose being accompanied with psychogenic hearing loss; we should evaluate objective tests, such as DPOAE.

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