Peter H K Mak1, Paul S Tumber. 1. Department of Anesthesia, Division of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. peter.mak@uhn.on.ca
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.
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.