Reversible bilateral sensorineural hearing loss associated with atorvastatin: a case report

BACKGROUND: Atorvastatin is widely prescribed for hyperlipidemia and is generally well tolerated. Auditory adverse effects are rarely reported, and statin-associated sensorineural hearing loss (SNHL) remains poorly characterized. CASE PRESENTATION: A 45-year-old Ethiopian woman developed bilateral tinnitus followed by progressive, symmetric bilateral SNHL 3 weeks after starting atorvastatin 40 mg daily. She had no other ototoxic risk factors. Pure-tone audiometry confirmed bilateral moderate SNHL. Given the temporal association and exclusion of alternatives, atorvastatin was discontinued. One week later, audiometry showed improvement to mild hearing loss, and at a 1-month follow-up, thresholds normalized with complete symptom resolution. She was subsequently switched to rosuvastatin 20 mg daily, with no recurrence at a 6-month follow-up. CONCLUSION: This case demonstrates that atorvastatin-associated SNHL can be reversible when recognized early. Prompt identification of new auditory symptoms and timely discontinuation of the offending medication may prevent permanent hearing impairment.