Temporal bone pathology of a patient without hearing and caloric reaction, and with counter-rolling after chronic myelocytic leukemia.

The temporal bone pathology of a 36-year-old man who suffered from chronic myelocytic leukemia and sudden hearing loss of both ears, was studied from the viewpoint of neurotology. Neurotological examination showed bilaterally profound hearing loss and no caloric reaction but good counter-rolling reaction to the right and the left head tilt and no other abnormal neurological findings. He died of intracranial hemorrhage. A study of histopathology of the temporal bones revealed extensive destruction of the organ of Corti, dilatation of Reissner's membrane, leukemic infiltration in the cochlea but good preservation of sensory hair cells in the vestibular endorgans. Leukemic cell infiltration in perilymphatic and endolymphatic spaces, and leukemic hemorrhage in the perilymphatic spaces were observed. And also in the left internal auditory canal, obvious leukemic infiltration and marked hemorrhage were observed, but in the right internal auditory canal, no abnormal change was found. We discuss the correlation between neurotological findings and histopathological findings.