Cochlear-vestibular dysfunction versus sudden cardiac supraventricular arrhythmia: Case report

Fractures to the petrous bone are a subject of great clinical interest and are often responsible for a large number of complications. Petrous bone fractures result from cranial injuries and, less frequently, can result from sporting injuries. The authors describe the case of a 55-year-old patient who presented with an episode of subjective vertigo, nausea, right ear fullness and tinnitus, associated with haemorrhage from the ear, auricular pain and retroauricular tension on the right. An initial ECG revealed a supraventricular tachysystolia with a ventricular response of 150 bpm, right bundle branch block (RBBB) and incomplete left bundle branch block (ILBBB) with subsequent spontaneous recovery of the normal sinus rhythm with RBBB and the presence of ILBBB. Audiological evaluation showed the presence of a right cochleovestibulopathy. A successive CT of the petrous/mastoid bones revealed the presence, on the right, of a series of multiple fractures to the mastoid, without osseous compression. Investigations carried out during hospitalization correlated with the audiological symptoms resulting from a fracture of the right petrous bone provoked by a fall due to a syncopal episode. The authors wish to stress the importance of a careful multidisciplinary evaluation in cases of disordered cochleovestibular function of a post-traumatic nature which cannot be immediately linked to known sources.