62-year-old woman with a history of hypertension, hypercholesterolemia and hypertriglyceridaemia. Urological history of high-grade infiltrating bladder tumour (G3T2 p53+ transitional cell carcinoma and carcinoma in situ in sample 1 of the standardised multiple biopsy).
After radical cystectomy with Studer type bladder reconstruction (G3 urothelial carcinoma of solid pattern, pt3b, negative nodes) she presented with sepsis of urinary origin and was admitted to the semi-critical unit with intensive antibiotic and diuretic treatment.
Three days after admission, the patient reported sudden onset tinnitus accompanied by bilateral hypoacusis of a significant degree. The patient had no vertiginous or unstable symptoms. There was no otalgia, otodynia or sensation of otic fullness. Facial mobility was preserved.
The physical examination was strictly normal, with audiometry revealing profound hypoacusis of the right ear and cophosis of the left ear, with normal impedance testing.

Once the sensorineural nature of the hearing loss had been confirmed, a review of the patient's clinical history and a new anamnesis were carried out in order to carry out an aetiological study. Once the relationship with systemic diseases, intracranial infections and trauma was ruled out, the hypoacusis was attributed to the administration of intravenous furosemide in the initial management of septic shock.
Furosemide administration was discontinued, and the association of other ototoxic drugs was proscribed. Treatment with high-dose parenteral corticosteroids (methylprednisolone 120 mg/24) and oral pentoxifylline (400 mg/ 8 h) was given according to the protocol for sudden hearing loss. (400 mg/ 8 h). After 7 days of parenteral treatment, oral corticosteroid treatment was continued in a descending pattern for a further 14 days (Prednisone 60 mg/day for 7 days and 30 mg/day for 7 days), maintaining pentoxifylline at the same dose for several months. Audiometry two weeks after treatment showed an improvement in tonal hearing with the appearance of auditory traces in the low frequencies in the left ear and an increase in the thresholds in the right ear.

Six months after treatment, the patient's hearing in the right ear has recovered to 58%. The left ear has residual hearing in the low frequencies, but no clear recovery has been observed. The patient continues to be monitored at our centre, and the fitting of an acoustic prosthesis in the right ear has been recommended. Oncologically, she has started complementary treatment with chemotherapy, without affecting her hearing levels.