ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Case report and literature review of subclavian steal syndrome presenting with otologic symptoms as the initial clinical manifestation.
Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSubclavian steal syndrome (SSS) seldom manifests with isolated otologic symptoms, and sudden sensorineural hearing loss (SSNHL) as the initial presentation is infrequent. This case underscores the critical-though often overlooked-relationship between vertebrobasilar hemodynamics and inner ear perfusion, broadening the differential diagnosis for acute audiovestibular complaints. CASE PRESENTATION: A 51-year-old female presented with sudden-onset left-sided sensorineural hearing loss, recurrent vertigo, and ischemic manifestations in the left upper extremity. Audiometric assessment confirmed severe acute sensorineural hearing loss, and vestibular evaluation indicated labyrinthine impairment. Doppler ultrasonography revealed retrograde flow in the left vertebral artery. Subsequent computed tomographic angiography and digital subtraction angiography identified critical stenosis of the proximal left subclavian artery, accompanied by a classic subclavian steal phenomenon. The patient underwent percutaneous transluminal angioplasty and stent placement.
resultsFollowing vascular reconstruction surgery, the patient's symptoms of dizziness and upper-limb ischemia improved significantly. Nevertheless, hearing recovery remained limited. Subsequently, due to economic factors, the patient did not undergo further diagnostic or therapeutic measures.
conclusionThis case demonstrates that SSS can present initially with sudden hearing loss and vertigo, underscoring the importance of otolaryngologists maintaining a high index of suspicion for vascular causes in atypical SSNHL. Early vascular imaging and prompt restoration of blood flow are critical to avoid permanent cochlear injury. This report enhances clinical recognition of rare vascular origins of inner ear ischemia and underscores the pathophysiological dissociation between vestibular recovery and auditory outcomes.
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