Sensorineural Deafness After Spine Surgery: Case Series and Literature Review.World Neurosurg 2019; 131:e482-e485WN
Sudden sensorineural hearing loss (SNHL) after nonotologic surgery is unusual, with most occurrences reported in patients having cardiopulmonary bypass. Reports of SNHL after nonotologic noncardiac surgery are rare, particularly after spine surgery. In patients undergoing subarachnoid anesthesia or intradural surgery, loss of cerebrospinal fluid pressure can result in hearing loss and cranial nerve palsy.
A 70-year-old male patient had ankylosing spondylitis with an Anderson lesion T11-12 with diabetes mellitus, hypertension, and American Spinal Injury Association Impairment Scale-A neurology. He underwent posterior stabilization of T10-L1 and developed a profound, painless, left-sided hearing deficit shortly afterward. An otorhinolaryngology consultation confirmed SNHL. An 82-year-old male reported claudication with L4-5 LCS and type 2 diabetes mellitus. Post L4-5 transforaminal lumbar interbody fusion, he complained of hearing loss in his left ear, confirmed by an otolaryngologist. A 72-year-old diabetic male had tuberculous spondylodiskitis of D2-3 with an epidural abscess. An emergent decompression and stabilization C7-D5 bone grafting at D2-3 was done. In the early postoperative period, the patient complained of marked hearing impairment on the right side. Audiometry indicated SNHL in his right ear.
A course of intravenous corticosteroids was instituted in the first and second patients for severe hearing loss. Steroids were not given to the third patient in view of his Pott spine. No improvement in hearing impairment occurred until the latest follow-up in all patients.
Sudden-onset hearing loss post spine surgery is disastrous with multiple etiologies and remains poorly understood. Timely evaluation by an otolaryngologist and audiologist is recommended. The role of corticosteroids in treating SNHL is still unclear.