Endocrine Abstracts

Background: Acromegaly is an orphan neuroendocrine disease characterized by a variety of complications. Due to slow symptom progression acromegalic patients often are involved in growth hormone complications correction for a long time instead of search for main cause of these multiple disorders. A view on conductive hearing loss in acromegaly in literature is contradictory. The low incidence of hearing in acromegaly, compared with other complications, is presumably due to the topographic and anatomical location of the pituitary tumor.

Case presentation.: Female patient, 29 years old, was hospitalized in an endocrinological hospital in 2022 with suspected active stage of acromegaly and pituitary adenoma measuring 57×35×32 mm with endo-supra-infra-ante-latero(D+S) sellar growth, chiasm compression (greater on the left), with tumor expansion into in the main sinus and cells of the ethmoid labyrinth, as well as in the cavernous sinuses, more in the left. According to the hormonal study, IGF-1 was 645.2 ng/ml (normal to 311) and growth hormone more than 80 ng/ml (up to 6.9), which confirmed the hormonal activity of the adenoma. The patient complained of a significant hearing loss and was consulted by an otolaryngologist. Based on the conducted audiometry, chronic bilateral sensorineural hearing loss III degree on the right and I degree on the left, as well as a bilateral increase in the perception thresholds of the III degree on the right and I degree on the left, was diagnosed. Because of transnasal transsphenoidal adenomectomy was performed. According to the results of immunohistochemical study – sparsely granulated somatotropinoma. After surgical treatment, the patient noted an improvement in hearing, repeated audiometry confirmed the positive dynamics of auditory function – a diagnosis of minimal bilateral chronic conductive hearing loss of the 1st degree was established. Such dynamics confirmed the genesis of hearing impairment as a result of hypertrophy of the temporal bone, due to hyperproduction of growth hormone, with subsequent damage to the auditory analyzer of the inner ear.

Conclusions: This clinical case shows the presence of conductive hearing loss in acromegaly and its reversibility after surgical treatment. Allied physicians should be aware of the variety of symptoms and complications of acromegaly, pay attention not only to the main reason for contacting a specialist, but also to the appearance of the patient, accompanying complaints.