Hearing Loss as a Sequel of Lumbar Puncture

Abstract

Only a few case reports have been published about hearing impairment following lumbar puncture, and not all were thoroughly documented by audiograms. We present nine cases of hearing loss following myelography, lumbar puncture, and spinal anesthesia. We speculate that this rare complication arises only in persons with a wholly or partially patent cochlear aqueduct, and occurs via the release of perilymphatic fluid in the cerebrospinal space. Hearing loss was seen in eight of the nine patients in the lower frequencies, and in six of the nine patients on both sides. Recovery to normal hearing was noticed in six of the nine patients. Transient hearing loss may occur more often than it is generally assumed, and the symptom can remain unnoticed. Since not all of these hearing losses proved to be fully reversible, we suggest informing patients about this complication for medicolegal reasons.

Flow-regulated external lumbar drain: applications and complications

“…A similar application is during open or endovascular thoracoabdominal aortic artery aneurysm repair, for intraoperatively preventing or postoperatively treating spinal cord ischaemia [15]. A useful application of FRED, as we also showed, is in the diagnosis of NPH or the treatment of idiopathic intracranial hypertension, as serial lumbar taps are uncomfortable for the patient and hold a number of complications (cranial nerve VI and VIII palsies [16][17][18], spinal epidural CSF collection [19] and chronic tonsilar herniation-"acquired" Chiari malformation [20]). …”

Role of repeated epidural injections in preventing post-spinal hearing loss

“…Increase in epidural pressure by epidural injection has been used to treat hearing loss [17]. Although there is no comparison of hearing loss with SSS and CSE with epidural volume extension, there is one trial, by Kilickan et al [16], comparing SSS with CSE without epidural volume extension.…”

Hearing loss in hydrocephalus: a review, with focus on mechanisms

“…Subtle effects of CSF loss on hearing loss may be more common; a study of 34 patients administered spinal anesthesia found a consistently elevated hearing threshold at 500 Hz, with one patient demonstrating pronounced unilateral hearing loss that resolved after epidural blood patching [121]. Similarly, there exist several case reports of hearing loss after lumbar puncture or lumbar myelography with transient, low frequency hearing loss that was responsive to epidural blood patching [73,83,90,99].…”

“…Hearing loss has been described following neurosurgery, lumbar puncture, myelography, and spinal anesthesia. Complete recovery of auditory function typically occurs within days of the procedure [73,83,90,99,123,124]. In contrast, chronic hearing loss has been described in patients with hydrocephalus [34,63,108] and other disorders of CSF pressure [32,52,81,92,94,104,105].…”