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Suwannatrai P, Chaiyakulsil C. Hearing screening outcomes in pediatric critical care survivors: a 1-year report. Acute Crit Care 2022; 37:209-216. [PMID: 35280037 PMCID: PMC9184986 DOI: 10.4266/acc.2021.00899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/13/2022] [Indexed: 11/30/2022] Open
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Sensorineural hearing loss following lumbar puncture, spinal anaesthesia or epidural anaesthesia: a case series and literature review. The Journal of Laryngology & Otology 2022; 136:271-278. [DOI: 10.1017/s0022215122000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundSensorineural hearing loss following spinal anaesthesia, epidural anaesthesia or lumbar puncture is a rare phenomenon that is thought to occur when reduced cerebrospinal fluid pressure is transmitted to the inner ear through an enlarged cochlear aqueduct.MethodThis study presents two cases of sensorineural hearing loss following spinal anaesthesia for caesarean section as well as presenting results of a systemic review of the available literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Full-text articles from Medline, PubMed and Embase were used, as well as associated reference lists. Risk factors associated with poorer outcomes and an approach to management of this rare condition are also discussed.ResultsTwenty-one cases were identified. The literature was systematically reviewed showing presentations, investigations performed, treatments offered and outcomes.ConclusionSensorineural hearing loss following spinal anaesthesia, epidural anaesthesia or lumbar puncture is a rare occurrence that requires a high degree of clinical suspicion and prompt investigation and treatment.
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Abstract
OBJECTIVES Tinnitus and hearing loss commonly coexist, however, the temporal relation between tinnitus and hearing loss is complex and not fully understood. Our objective was to examine the longitudinal association between persistent tinnitus, bothersome tinnitus, and 3-year elevation of audiometric hearing thresholds. DESIGN We conducted a longitudinal cohort study among 3106 women (mean age 59 years) who were participants in the Nurses' Health Study II (2012-2018). Information on tinnitus was obtained from biennial questionnaires. Longitudinal changes in air conduction thresholds (0.5 to 8 kHz) were assessed by pure-tone audiometry conducted by licensed audiologists at 19 audiology testing sites across the United States. Logistic regression was used to estimate multivariable-adjusted odds ratios (MVORs, 95% confidence interval [CI]) and evaluate the relations of persistent tinnitus (several days per week or more), bothersome tinnitus (interferes with work, sleep, or daily activities), and risk of 3-year elevation of hearing thresholds. RESULTS Persistent tinnitus was associated with higher risk of 3-year elevation of hearing thresholds across a broad range of frequencies. Compared with women without tinnitus, the MVORs (95% CI) for ≥5-dB threshold elevation among women with persistent tinnitus were 1.01 (0.81, 1.25) at 0.5 kHz, 1.45 (1.17, 1.81) at 1 kHz, 1.25 (1.00, 1.56) at 2 kHz, 1.34 (1.07, 1.69) at 3 kHz, 1.34 (1.06, 1.70) at 4 kHz, 1.49 (1.16, 1.91) at 6 kHz, and 1.63 (1.25, 2.12) at 8 kHz. The magnitudes of the associations for ≥10-dB threshold elevation were similar. The magnitudes of the associations were substantially greater among women with bothersome tinnitus. For example, compared with women without tinnitus, the MVORs (95% CI) for a ≥5- and ≥10-dB elevation of hearing thresholds at 4 kHz were 2.97 (1.50, 5.89) and 2.79 (1.38, 5.65), respectively. The risk was elevated even among women with tinnitus who had clinically normal hearing thresholds at baseline. In analyses that examined the association of tinnitus and elevation of low-, mid- and high-frequency pure-tone average (PTA) hearing thresholds, the results were similar. Compared with women without tinnitus, the MVORs (95% CI) for ≥5-dB PTA elevation among women with persistent tinnitus were 1.29 (0.99,1.67) for LPTA(0.5,1,2 kHz); 1.44 (1.16, 1.78) for MPTA(3,4 kHz); and 1.38 (1.11, 1.71) for HPTA(6,8 kHz). For ≥10-dB elevation, the MVORs were 2.85 (1.55, 5.23), 1.52 (1.10, 2.09), and 1.41 (1.10, 1.82), respectively. CONCLUSION Persistent tinnitus was associated with substantially higher risk of 3-year hearing threshold elevation, even among women with clinically normal baseline hearing. The magnitudes of the associations were greater among those with bothersome tinnitus. Monitoring hearing sensitivities may be indicated in patients with tinnitus, including those without audiometric evidence of hearing impairment.
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Vahabi S, Veiskarami P, Roozbahani M, Lashani S, Farzan B. Cross-sectional study on hearing loss and auditory reaction time before and after spinal anesthesia with marcaine 0.5% in patients undergoing elective surgery. Ann Med Surg (Lond) 2020; 60:236-240. [PMID: 33194180 PMCID: PMC7645317 DOI: 10.1016/j.amsu.2020.10.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 01/16/2023] Open
Abstract
Background Hearing loss is a rarely reported complication of spinal anesthesia. The purpose of this study is to assess the effects of 0.5% Maracine (bupivacaine) on hearing threshold and auditory reaction time before and after spinal anesthesia among patients undergoing elective surgery. Materials and methods This is a descriptive cross-sectional study performed on 60 patients undergoing elective surgery with ASA Class II and II anesthesia (0.5% bupivacaine) at Khorramabad Nursing Home. After obtaining consent from the patients, audiometry and tympanometry tests were performed using AZ80 and Madsen otoflex tympanometer and related findings including the presence or absence of hearing loss at various frequencies, before and after the surgery, were noted in a form for each patients along with their demographic data. SPSS 21 was used for statistical analysis and the data were analyzed using descriptive statistics and chi-square inferential tests. Results At low frequencies of 250 and 500 Hz, no significant difference in pre- and postoperative hearing threshold in the right ear (P > 0.05) was seen, but at frequencies above 500 Hz, the hearing threshold was significantly decreased after surgery, (P < 0.05). In the left ear at 250, 1000, 3000, and 8000 Hz, there was no significant difference (P > 0.05) between pre- and postoperative hearing threshold. The results of this study showed that the preoperative hearing threshold for men and women did not differ and the auditory threshold and auditory response time after surgery did not differ between the two sexes (P > 0.05). Similarly, the difference was not correlated with the age and the levels of anesthesia (P > 0.05). The results also showed that changes in mean arterial blood pressure (MAP) and heart rate above 30% of baseline were also not correlated with hearing loss (P > 0.05). Conclusions The results showed that at certain frequencies, hearing loss was observed in both ears after spinal anesthesia with 5% Marcaine, but this hearing loss was not related to age, sex, and spinal anesthesia level. The results also showed that changes in mean arterial blood pressure (MAP) and heart rate above 30% of baseline did not correlate with hearing loss. Hearing loss is a rarely reported complication of spinal anesthesia. Hearing loss in both ears is observed after spinal anesthesia with 5% Marcaine. Changes in MAP and heart rate greater than 30% of baseline is not associated with the hearing loss.
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Affiliation(s)
- Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parvin Veiskarami
- Department of Audiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Roozbahani
- Department of Motor Behavior, Borujerd Branch, Islamic Azad University, Borujerd, Iran
| | - Shahrzad Lashani
- Student Research Committee, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Behrouz Farzan
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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KÖLÜKÇÜ V, GÜRLER BALTA M. Unilateral low-frequency hearing loss after spinal anesthesia: a case report. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.749632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Yakıştıran B, Karslı M, Canpolat E, Oğuz Y, Altınboğa O, Celen S. The Effect of Anesthesia Type During Delivery on Neonatal Otoacoustic Emission Hearing Test Results: A Tertiary Center Experience. Z Geburtshilfe Neonatol 2020; 225:262-266. [PMID: 32992403 DOI: 10.1055/a-1253-8727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Hearing is essential for the healthy development of an infant as language is one of the main stimulants of intellectual capacity. We investigate the effect of anesthesia type during delivery on neonatal otoacoustic emission (OAE) hearing test results. METHODS This retrospective cross-sectional study includes 1,493 healthy, full-term (39/0-40/6 gestational weeks) newborns of healthy women and who were delivered by cesarean section. Newborns were divided into 2 groups based on their anesthesia type during delivery: 1) general anesthesia group (n=160), and 2) spinal anesthesia group (n=1333). Maternal age, anesthesia type, birth weight, gestational age at birth, neonatal gender, 1st-5th minute APGAR scores, and OAE results were compared between the groups. RESULTS 1287 (86.2%) newborns were reported to have passed the first step of OAE; 206 (13.8%) newborns were reported to have failed the first step and passed the second test. In the general anesthesia group, 133 (83.1%) of the newborns passed the first OAE test and 27 (16.9%) newborns had false-positive results. In the spinal anesthesia group, 1,154 (86.6%) of the newborns passed the first OAE test and 179 (13.4%) newborns had false-positive results. The difference between the 2 groups by false-positive values was found to be statistically significant (p<0.001). CONCLUSIONS Type of delivery anesthesia may have an effect on the false-positive rates of OAE test results.
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Affiliation(s)
- Betül Yakıştıran
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital
| | - Mehmet Karslı
- Obstetrics and gynecology, Istanbul Universitesi-Cerrahpasa, Istanbul, Turkey
| | - Emre Canpolat
- Neonatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Yüksel Oğuz
- Obstetrics and gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Orhan Altınboğa
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital
| | - Sevki Celen
- Obstetrics and gynecology, Etlik İhtisas Eğitim ve Araştırma Hastanesi, Ankara, Turkey
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Mallepally AR, Rustagi T, Chhabra HS, Gupta A. Sensorineural Deafness After Spine Surgery: Case Series and Literature Review. World Neurosurg 2019; 131:e482-e485. [PMID: 31382067 DOI: 10.1016/j.wneu.2019.07.204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
| | - Tarush Rustagi
- Department of Spine Services, Indian Spinal Injuries Centre, New Delhi, India
| | | | - Anuj Gupta
- Department of Spine Services, Indian Spinal Injuries Centre, New Delhi, India
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Lee CJ, Yoo BW, Kim JS, Cho SH, Jeong EK. Unilateral sudden sensorineural hearing loss after combined spinal-epidural anesthesia for emergency cesarean section -A case report-. Anesth Pain Med (Seoul) 2016. [DOI: 10.17085/apm.2016.11.4.359] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chang-Joon Lee
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Byoung-woo Yoo
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Jin Sun Kim
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Sang-hyeon Cho
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Eui-kyun Jeong
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Gangneung, Korea
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Colpan B, Apiliogullari S, Erdur O, Celik JB, Duman A, Senaran H, Ozturk K. The effects of spinal anesthesia on auditory function in pediatric patients. Int J Pediatr Otorhinolaryngol 2016; 88:199-202. [PMID: 27497414 DOI: 10.1016/j.ijporl.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Persistent or transient hearing loss (HL) is a less-recognized complication of spinal anesthesia (SA) in the pediatric population, although it has been previously reported in adults. The primary aim of this study was to investigate the effects of SA on auditory function in the pediatric population. METHODS After gaining institutional approval and parental consent, 30 American Society of Anesthesiologists physical status I-II children between 4 and 15 years undergoing lower extremity orthopedic surgery were enrolled in this prospective study. Spinal blocks were performed in the midline with a 25G Quincke needle using 0.5% hyperbaric bupivacaine. Transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests were administered before surgery and one-day postoperative. Children with detected HL were retested on postoperative day seven. Preoperative and postoperative results were compared. A Wilcoxin Signed-Ranks test (with Bonferroni correction) was used for statistical analyses. RESULTS There was no statistically significant HL in the postoperative period compared to the preoperative period. In 29 of 30 patients, no difference was detected at any frequency tested. In one patient, TEOAE and DPOAE tests were found to be decreased on postoperative day one. In this patient, control tests were found to be improved on postoperative day seven. CONCLUSIONS Administration of SA may results in a low probability of transient hearing loss with no clinical significance in children 4-15 years of age.
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Affiliation(s)
- Bahar Colpan
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
| | - Seza Apiliogullari
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Omer Erdur
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
| | - Jale Bengi Celik
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Ates Duman
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Hakan Senaran
- Selcuk University Medical School, Department of Orthopedics, Konya, Turkey.
| | - Kayhan Ozturk
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
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Yildiz TS, Solak M, Iseri M, Karaca B, Toker K. Hearing Loss after Spinal Anesthesia: The Effect of Different Infusion Solutions. Otolaryngol Head Neck Surg 2016; 137:79-82. [PMID: 17599570 DOI: 10.1016/j.otohns.2007.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 02/13/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE: We speculate that the preoperative volume replacement with a convenient solution may protect the inner ear function after spinal anesthesia. METHODS: The patients were randomized in a single-blind fashion into two groups: group LR (n = 40) received lactated Ringer's and group GF (n = 40) received gelatin polysuccinate 4% (Gelofusine). Spinal anesthesia was performed with a 25 G Quincke needle and was given bupivacaine 0.5% 10 mg and fentanyl 25 jxg. Audio-grams were performed preoperatively and 2 days postoperatively. RESULTS: The overall incidence of hearing loss was 7.5%. The hearing loss was unilateral in two and bilateral in four patients. Hearing loss occurred within the low-frequency range and the hearing thresholds returned to normal by the fifth postoperative day. CONCLUSIONS: Although the incidence of hearing loss for the lactated Ringer's group was higher than the Gelofusine group, there was no statistically significant difference between the groups. For medicolegal and ethical reasons, patients should be informed about the possibility of hearing loss after spinal anesthesia.
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Affiliation(s)
- Tulay Sahin Yildiz
- Department of Anesthesiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey
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Janecka-Placek A, Lisowska G, Paradysz A, Misiołek H. Cochlear Function Monitoring after Spinal Anesthesia. Med Sci Monit 2015; 21:2767-73. [PMID: 26377393 PMCID: PMC4578649 DOI: 10.12659/msm.893718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of the study was to examine the effect of spinal anesthesia on the function of cochlear outer hair cells (OHCs), determined by means of objective distortion product otoacoustic emissions (DPOAE) testing. To the best of our knowledge, our study was the second OAE-based analysis of cochlear function during spinal anesthesia, and the only experiment including such a large group of patients. Material/Methods The study included 20 patients (18 men and 2 women) subjected to a scheduled uretherorenoscopic lithotripsy with routine spinal anesthesia with 10 mg (2 ml) of 0.5% hyperbaric bupivacaine and 50 μg (1 ml) of fentanyl. The levels of DPOAEs and background noise at 1000–6000 Hz were recorded prior to and immediately after the anesthesia, and on the postoperative day 2. Results We did not find significant differences between DPOAEs values recorded prior to and immediately after the anesthesia. The only exception pertained to 5652 Hz, at which a significantly higher level of DPOAEs was observed immediately after the anesthesia. The levels of DPOAEs at 2002 Hz and 2380 Hz collected on the postoperative day 2 were significantly higher than the respective baseline values. Irrespective of the frequency and time of testing, we did not find any significant differences between the recorded levels of background noise. Conclusions Our findings point to the lack of a detrimental effect of spinal anesthesia on objectively evaluated cochlear function, and thus suggest that this method is safe, even for OHCs, which are extremely susceptible to exogenous and endogenous injuries.
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Affiliation(s)
- Agata Janecka-Placek
- Department of Anesthesiology and Intensive Therapy in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Grażyna Lisowska
- Department of Otolaryngology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Paradysz
- Department of Urology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Hanna Misiołek
- Department of Anesthesiology and Intensive Therapy in Zabrze, Medical University of Silesia, Zabrze, Poland
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Sudden bilateral hearing loss after spinal anaesthesia. The Journal of Laryngology & Otology 2015; 129:395-7. [DOI: 10.1017/s0022215115000432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground:Spinal anaesthesia is one of the most widely used regional anaesthesia techniques. Sudden bilateral hearing loss following spinal anaesthesia has only been reported in a few cases.Case report:This paper reports the case of a 50-year-old woman who developed sudden bilateral hearing loss following spinal anaesthesia for hallux valgus orthopaedic surgery. This is followed by a literature review.Results:The patient's hearing improved almost completely on the morning of the 3rd day following surgery. No recurrence of hearing loss, tinnitus or vertigo was reported during the six-month follow-up period.Conclusion:Some complications regarding hearing may emerge after spinal anaesthesia. The possibility of hearing loss after spinal anaesthesia should be taken into consideration. Complaints such as hearing loss, tinnitus or vertigo should be taken seriously when reported, and the patient should be referred to an ENT clinic. This will ensure early diagnosis and treatment.
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Aydin N, Aydin Y, Uludag S. Sudden sensorineural hearing loss after laparoscopic cystectomy under general anaesthesia. J OBSTET GYNAECOL 2014; 35:206-8. [DOI: 10.3109/01443615.2014.935722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tyagi A, Gupta U, Kumar A, Sethi AK, Mohta M. Role of repeated epidural injections in preventing post-spinal hearing loss. J Clin Anesth 2011; 22:587-91. [PMID: 21109129 DOI: 10.1016/j.jclinane.2010.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 03/08/2010] [Accepted: 03/11/2010] [Indexed: 10/18/2022]
Abstract
STUDY OBJECTIVE To determine if epidural volume extension and continued postoperative epidural injections prevent hearing loss associated with a 23-gauge (G) Quincke spinal needle. DESIGN Prospective, double blinded trial. SETTING Operating rooms. PATIENTS 30 adult patients scheduled for lower abdominal or perineal surgery during spinal anesthesia. INTERVENTIONS Patients were divided into two groups of 15 each. All patients received subarachnoid injection with a 23-G Quincke needle. While patients in Group S received a single-shot spinal, Group E patients underwent epidural catheter placement one intervertebral space above. The epidural catheter was bolused with 10 mL of normal saline followed by postoperative epidural boluses of local anesthetic for analgesia as needed. MEASUREMENTS Patients' auditory function was evaluated by pure tone audiometry (frequencies of 250-8,000 Hz) on the day before and two days after receiving the spinal anesthesia. MAIN RESULTS Unilateral low-frequency hearing loss (500 Hz) was seen in Group S (P < 0.05). It was prevented by the repeated epidural injections as used in Group E. CONCLUSION Following spinal anesthesia, epidural volume extension with 10 mL of normal saline followed by epidural local anesthetic boluses titrated to adequate postoperative analgesia (6-8 mL each time) prevents post-spinal hearing loss.
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Affiliation(s)
- Asha Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahadra, Delhi-110095, India.
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Erol A, Topal A, Arbag H, Kilicaslan A, Reisli R, Otelcioglu S. Auditory function after spinal anaesthesia: the effect of differently designed spinal needles. Eur J Anaesthesiol 2009; 26:416-20. [DOI: 10.1097/eja.0b013e32831c89d4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Güçlü E, Demiraran Y, Sezen G. Hearing loss after spinal anaesthesia: comparison of 22 and 25 G Quincke needles in a non-elderly population. Clin Otolaryngol 2006; 31:344-6. [PMID: 16911667 DOI: 10.1111/j.1749-4486.2006.01245.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karatas E, Göksu S, Durucu C, Isik Y, Kanlikama M. Evaluation of Hearing Loss after Spinal Anesthesia with Otoacoustic Emissions. Eur Arch Otorhinolaryngol 2006; 263:705-10. [PMID: 16680466 DOI: 10.1007/s00405-006-0049-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 01/27/2006] [Indexed: 10/24/2022]
Abstract
The aim of this study was to determine the degree and reversibility of hearing loss (HL) following spinal anesthesia with an objective audiometric test: otoacoustic emissions (OAE). Eleven patients (22 ears) who were undergoing surgery under spinal anesthesia were included in this study. Transient-evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) were evaluated 1 day before the operation and postoperative day 1, 2, and 15. DPOAE were recorded as DPgram and input/output functions (I/O). The emission amplitudes of the TEOAE and DPOAE of right and left ears were found to be affected immediately after the surgery and progressive improvement detected with full recovery within postoperative 15 days. These changes were mainly at around 1,500-3,000 Hz. None of the patients had permanent OAE amplitude deterioration. Transient HL may occur more often than it is generally assumed, and the symptoms might not be recognized. OAE is an effective and objective way of evaluating the HL in this particular group of patients. We suggest informing patients about this transient HL for medicolegal issues.
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Affiliation(s)
- Erkan Karatas
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Sahinbey Medical Center, Gaziantep University, 27060 Gaziantep, Turkey.
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Gladstone JP, Dodick DW. Isolated sudden-onset hearing loss as a manifestation of recurrent CSF leak. Cephalalgia 2005; 25:550-3. [PMID: 15955045 DOI: 10.1111/j.1468-2982.2005.00883.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J P Gladstone
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
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Diaz JH. Treatment Outcomes in Spontaneous Intracranial Hypotension: Do Epidural Blood Patches Stop the Leaks? Pain Pract 2004; 4:295-302. [PMID: 17173611 DOI: 10.1111/j.1533-2500.2004.04405.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Spontaneous intracranial hypotension (SIH) is a postural headache syndrome unrelated to dural puncture. Because of the increasing failure of epidural blood patch (EBP) to relieve headache in SIH, we retrospectively investigated the epidemiological features and treatment outcomes in 55 cases of SIH. The study population was stratified by age and sex; continuous variables were compared for differences by t-tests; categorical variables were compared by Chi-squared analysis or Fisher exact tests. Significant differences were identified by P values of 0.05 or less. The mean age of the study population was 44 +/- 12 years with a female to male ratio of 1.3:1.0. Men presented with subdural hematomas (P = 0.001) more often than women. Meningeal enhancement on contrast magnetic resonance imaging (MRI) was the most consistent radiographic finding. Radionuclide cisternography (RC) demonstrated thoracolumbar dural leaks in 16 of 22 patients. EBP failures were more common in patients aged 40 and younger than in older patients (P = 0.003). Postural headache from SIH was not uniformly responsive to EBP, and had significant comorbidities, especially in men. The management of postural headache in SIH by other techniques to restore brain position and cerebrospinal fluid dynamics should be investigated.
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Affiliation(s)
- James H Diaz
- School of Medicine, Louisiana State University Health Sciences Center in New Orleans, New Orleans, Louisiana 70112, USA.
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Ok G, Tok D, Erbuyun K, Aslan A, Tekin I. Hearing loss does not occur in young patients undergoing spinal anesthesia. Reg Anesth Pain Med 2004. [DOI: 10.1097/00115550-200409000-00007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kiliçkan L, Gürkan Y, Aydin O, Etiler N. The effect of combined spinal-epidural (CSE) anaesthesia and size of spinal needle on postoperative hearing loss after elective caesarean section. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2003; 28:267-72. [PMID: 12755770 DOI: 10.1046/j.1365-2273.2003.00708.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The exact aetiology of vestibulocochlear dysfunction after spinal anaesthesia is unknown. Low-frequency hearing loss occurs after spinal anaesthesia. The aim of this study was to investigate the effects of combined spinal-epidural (CSE) anaesthesia and size of spinal needle on vestibulocochlear dysfunction, using pure tone audiometry performed pre- and on the first and the second day postoperatively. Forty-five patients who were to undergo elective caesarean section were evaluated. In group I, CSE anaesthesia (18 G Tuohy, 25 G Whitacre pencil-point-design spinal needles) was performed in 15 patients. In group II, spinal anaesthesia was performed in 15 patients with 25 G Whitacre pencil-point-design spinal needles and, in group III, spinal anaesthesia was performed in 15 patients with 22 G Whitacre pencil-point-design spinal needles. In the pre- and on the first and the second day postoperatively, the pure tone audiogram was performed in the audiology laboratory of our hospital, using a calibrated Kamplex Diagnostic Audiometer AC 40 in a noise-free room. When the CSE anaesthesia group and 22 G spinal group were compared for change in hearing between the pre- and postoperative periods, a statistically significant difference was observed at R-right ear 125 Hz (P < 0.025) and at L-left ear 125 Hz (P < 0.023), and at L-left ear 1000 Hz (P < 0.036) and at R-right ear 1500 Hz (P < 0.006), and at L-left ear 1500 Hz (P < 0.022). At other frequencies, the difference was insignificant. When the CSE anaesthesia group and 25 G spinal group were compared for change in hearing between the pre- and postoperative periods, no statistically significant difference was detected at any frequency tested. When 22 G spinal group and 25 G spinal group were compared for change in hearing between the pre- and postoperative periods, there was some hearing loss at low frequency, although this difference did not reach statistical significance. The positive correlation of low-frequency hearing loss and increased pressure in the epidural space (which decrease the risk of cerebrospinal fluid leakage through the dura) suggests that cerebrospinal fluid leakage via the spinal puncture hole is not the only factor involved. Perioperative fluid replacement alone may not prevent hearing loss but CSF loss through the dural puncture site should also be prevented.
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Affiliation(s)
- L Kiliçkan
- Department of Anaesthesiology and Reanimation, Kocaeli University School of Medicine, Turkey.
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Mak PHK, Tumber PS. Postoperative sudden sensorineural hearing loss after posterior lumbar decompression: a case report. Can J Anaesth 2003; 50:519-21. [PMID: 12734165 DOI: 10.1007/bf03021068] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE We report a case in which a patient sustained a dural tear during spinal surgery under general anesthesia complicated by a severe and persistent unilateral sensorineural hearing loss. CLINICAL FINDINGS A 51-yr-old man with no previous otological history underwent a posterior lumbar decompression surgery in the prone position under general anesthesia. A small dural tear was discovered intra-operatively and was repaired by sutures. Surgery lasted for eight hours with over 3 L of blood loss. Recovery from anesthesia was otherwise uneventful. A unilateral right-sided sensorineural hearing loss was discovered shortly after completion of surgery. This was associated with mild tinnitus but no vertigo. There was no aural fullness, pain, headache or postural element to his symptoms. Despite extensive investigations, treatment and follow-up by an otorhinolaryngologist, his symptoms failed to improve 18 months following surgery. DISCUSSION The possible etiologies, preventive strategies, prognosis and management plan of this rare complication are discussed.
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Affiliation(s)
- Peter H K Mak
- Department of Anesthesia, Division of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
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Epidemiology and Outcome of Postural Headache Management in Spontaneous Intracranial Hypotension. Reg Anesth Pain Med 2001. [DOI: 10.1097/00115550-200111000-00017] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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