Unilateral sensorineural hearing loss after spine surgery: case report and review of the literature

Background: Sudden sensorineural hearing loss is infrequent, with an estimated incidence of 5 to 20 cases yearly per 100000 people. Although multiple etiologies have been identified, infection and idiopathic SNHL are most common. Sudden sensorineural hearing loss after nonotologic noncardiac surgery is highly unusual, particularly after spinal surgery. Case Description: We report a case of unilateral sudden SNHL after lumbar spinal fusion with review of the literature. Potential etiologies, treatment, and prognosis are summarized. Conclusion: Multiple etiologies have been proposed for SNHL after nonotologic noncardiac surgery. Excessive positive upper airway pressure during induction of anesthesia or Valsalva maneuvers can result in SNHL from LMR. Aberrant NO accumulation in the middle ear cavity during general anesthesia with subsequent LMR is also a potential etiology, as is excessive leakage of CSF causing a form of endolymphatic hydrops. There is no definitive treatment of postoperative SNHL, although middle ear exploration may be beneficial for suspected overpressure injury to the middle ear, causing a perilymphatic fistula. Corticosteroids have been beneficial in certain cases of idiopathic SNHL; however, its effectiveness for postoperative SNHL is undocumented. (c) 2006 Elsevier Inc. All rights reserved.