Bilateral Sensorineural Hearing Loss After General Anesthesia for Basilar Invagination with Atlantolaxial Dislocation: a case report

Abstract

Background Sudden sensorineural hearing loss (SNHL) after nonotological surgery is unusual and unpredictable, usually occurring in cardiopulmonary bypass patients with unilateral deafness. A few bilateral SNHLs after spine surgery is reported. The literature is examined for early detection and management, and probable causes are outlined. Timing of onset and unilateral or bilateral symptoms may help determine etiology. Case Description: A 46-year-old woman with basilar invagination, atlantoaxial dislocation, immune system problems, and long-term hormone and immunosuppressant use. After a posterior occipital-cervical fusion under general anesthesia, the patient reported bilateral hearing loss and slurring 9 h later. A better MRI scan suggested a fresh brain infarct and increased pure tone audiometry revealed binaural SNHL. Anticoagulation, bacitracin, hyperbaric oxygen, and other symptomatic treatments improved the patient's hearing without affecting daily living. Following the treatment, the patient noted improved hearing, enabling her to talk at a normal distance and volume. Conclusions Hyperbolic oxygen and intravenous hormones may cure SNHL, a rare post-surgical spine surgery complication with different infections. Timing and symptoms are crucial for treatment and prognosis.