Pituitary macroadenomas are benign neoplasms that can cause a range of symptoms due to a mass effect on surrounding structures. This case report describes a 51-year-old male presenting with progressive bilateral hearing impairment and significant deterioration in speech discrimination over several years. Examination revealed normal tympanic membranes and no neurological deficits, while pure tone audiometry indicated mild to moderate sensorineural hearing loss. Magnetic resonance imaging identified a 6 × 5.5 × 7 cm pituitary macroadenoma extending into the suprasellar region and invading the sphenoid and right cavernous sinuses. The patient underwent a two-stage surgical intervention followed by gamma knife surgery. Postoperative follow-up showed mild deterioration in hearing with unmeasurable speech discrimination scores. This case underscores the importance of considering pituitary macroadenomas in the differential diagnosis of unexplained hearing loss and highlights the role of comprehensive audiological and imaging evaluations in achieving accurate diagnosis and optimal management.
Keywords: hearing loss; magnetic resonance imaging; pituitary macroadenoma; speech discrimination.