Spontaneous Recovery from Radiation Induced Unilateral Profound SNHL

Sensorineural hearing loss (SNHL) is a well-known side effect of radiation therapy for the treatment of cancerous cells or to shrink a mass before surgery. 

Researchers in Israel recently reported on a very unusual case. The patient is a 56-year-old male treated with radiation therapy for a jugular foramen schwannoma. Prior to radiation treatment, the patient had mild high-frequency hearing loss in both ears, right slightly poorer than left. He was seen at the author’s clinic to determine his candidacy for a cochlear implant in the right ear.

Two months following the patient’s last radiation treatment, he suddenly could not hear from the right ear. This was accompanied by aural fullness, tinnitus, and dizziness. Audiologic testing revealed no measurable hearing in the right ear and 0 percent-word recognition abilities. Corticosteroids were administered, but no improvement was noted. Five months later, the patient’s hearing had not changed.

One year after the loss of hearing in the right ear, the patient returned. Pure-tone air and bone conduction thresholds in the right ear were within normal limits from 250–2000 Hz. At 3,000-8,000 Hz, this ear continued to exhibit moderate-to-profound sensorineural hearing loss. A speech reception threshold (SRT) of 25 dB HL was obtained, and word recognition improved to 92 percent.

The authors hypothesize that a transient tumor expansion (edema) following radiation could account for the recovery. The lack of improvement at higher frequencies is likely due to damage to the cochlear hair cells. They report that while recovery of hearing is rare, clinicians should always conduct ongoing audiological monitoring in patients with post radiation hearing loss from skull base tumors.

Reference

Khoury, M., Egra-Dagan, D., Salman, S., et al. (2026). Unexpected spontaneous recovery from profound sensorineural hearing loss induced by radiation in a patient with a skull base tumor. Cureus, 18(3), e105290.