AUTHOR=Camurdan Aybige , Riemann Conrad , Brasch Frank , Todt Ingo 

TITLE=Case Report: A rare case of bilateral middle ear tophaceous gout

JOURNAL=Frontiers in Surgery

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2024.1353116

DOI=10.3389/fsurg.2024.1353116

ISSN=2296-875X

ABSTRACT=Hypacusia can be caused by various etiologies; however, hearing loss attributed to gouty tophi remains a rare occurrence. This case report represents for the first time a bilateral gouty tophi causing hearing impairment.This report presents a case study involving an 83-year-old Caucasian female patient 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. After the surgical removal of the tophus, a notable improvement in the patient's hearing threshold was observed. Four months later, a similar surgical intervention was performed on the contralateral ear, achieving a similar positive outcome. A substantial postoperative decrease of bone conduction indicates an inner ear affection by the gout tophi.Gout tophus in both ears is a very 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 in both ears, as a rare cause of hearing loss.