Sudden Hearing Loss and Tinnitus After Iodine Contrast (Iohexol Omnipaque 350) CT Scan

Long shot here, really. Has anyone else had sudden hearing loss and/or new onset tinnitus from a CT scan with contrast? I can only find one case of new onset hearing loss in the forums and about 4 cases of new onset tinnitus, so it seems quite rare after a CT contrast scan.

I had a CT scan of the abdomen, which wasn't really noisy at all. I had the Iodine/Iodinated contrast, the newer type Iohexol, which was specifically the Omnipaque 350 (the one with most Iodine in). Possible transient hearing loss and tinnitus are listed in the side effects. I drank a ton of water before and afterwards for a few days.

Sudden new hearing loss is in one ear only, unilateral, with hearing down by about 1/3. New onset medium-pitched tinnitus is on the same side. Both came on within about 24 hours of the CT scan.

 

Did you get on steroids for hearing loss as soon as possible?

 

Yes, I got on steroids pretty soon, but not immediately. I started after 12 days which seems to be within the 14 day guidelines. My doctor only put me on 40 mg Prednisolone though for a week, even though I discussed 60 mg which I understand is the usual accepted dose.

The good thing is it's moved in the right direction. The day after the CT scan, my hearing was about 70% of what is was before, now it's improved to 80% of what it was before, and the tinnitus is down by a third, so I'm glad for any improvement really.

The next decision is, I have an ENT appointment next week, which will be about the 3 1/2 week mark, and may be offered intratympanic steroid injections. Research papers on these do look promising, but after ploughing through this forum, not really one person seems to have any lasting improvement from them. Not sure it is effectively worth it or not for a now approximately 20% hearing loss and a bit more than mild tinnitus...?

 

Hello Peter, I've come across your post looking for information on reactions to CT scan contrast, as I am supposed to have one soon. Now I think I will try to do without May I ask if you have ever had any ototoxic damage prior?

As for the intratympanic injections, perhaps I can help - they have worked wonders for me, saved my hearing and sanity. The only thing that has ever worked (except for IV steroids, which come with more risk and side-effects). I have had ototoxic injury, acoustic trauma and barotrauma - I have tried pretty much everything over the past few years (multiple drugs, supplements, lasers, electrostimulation, osteopathy, acupuncture...), yet I quickly learned nothing can compete with the power of steroids. And I don't mean Prednisone - I took high doses (60 mg at 55 kg) for long periods, with no therapeutic effect at all.

Number one for effectiveness in my experience is IV Dexaven, which is Dexamethasone (I also got Piracetam and B12 shots), everyday for one week. This worked for me 2 months (!) after my first acoustic trauma - my hearing made FULL recovery. In my country this treatment is only available in a hospital setting though.

Number two is intratympanic injections - best ratio of effectiveness to safety, and much more accessible. At first the response was very slow, it took a few procedures to notice any improvement. But I kept going and at some point realised my tinnitus faded almost completely. I have had a few setbacks due to ototoxicity and noise, but I know I can always go back for a few shots and the improvement is now immediate and permanent (until the next incident ). I think what makes a big difference in individual response is the procedure protocol, which few people really stick to. I follow it to a t every time (lying motionless for 30-40 minutes with your head at a specific angle without swallowing or talking) - it may sound difficult, but it's doable and the silence is surely worth it I also always take Betaserc and NAC before the treatment, as according to research they boost steroid effectiveness and absorption.

So in short, if I were you, I would take as many of intratympanic shots as possible (with NAC and Betaserc), as soon as possible, and follow the guidelines as strictly as you can. I know in case of sudden deafness they are supposed to be done every day, in a series of 10. It's not a magic wand, but my hearing is now back to normal, tinnitus pretty much nonexistent - close enough for me

 

Hi Hanna. No ototoxic damage at all prior to this, it came totally out of the blue the next day after having CT contrast. I had 3 similar CT contrast scans in the 3 months preceding this with no ill effects. It's hard to say but you may probably be OK with CT contrast. I, from what I can see, seem to be the only one affected permanently after the CT contrast scan. I would think twice about having it again in my case though. I posted this to see if indeed there may be any others with the same experience too, but no one yet.

 

Thanks for your response. I feel a bit reassured, however knowing my luck when it comes to ears, if there is any risk at all, I could be that 2nd person I have read stress and infections are the main suspected causes of sudden deafness, have you considered these as possible causes?

The steroid I've been getting is Dexaven (dexamethasone), 4 mg (1 ml) per shot. It's hard to say about the timeframe or number, as my story has been quite eventful. All my major hearing loss has been successfully treated (3 times) with steroid IV, which I definitely recommend as first choice treatment. I had intratympanic steroid for tinnitus long after the onset (first round of 6 injections approximately 6 months later). Initially I was given cycles of 4 shots every 6 months, then more on on-demand basis, whenever I had a noise/ototoxic incident, every few months (as I was still learning what to avoid). I had immediate relief from tinnitus after each cycle, the more effective, the faster I acted - ideally up to a week or two, but the sooner, the better. In theory, steroid has the potential to protect/revive hearing cells up to 3 months after the damage. There is probably some other mechanism thanks to which it can gradually relieve tinnitus even much later, like in my case. Mostly I rely on it to prevent any new damage. But I'm hopefully smarter and more cautious too with time, and don't put myself at risk as much.

Hope it helps, good luck