[Chronic tinnitus and hearing loss caused by cerebrospinal fluid leak treated with success with peridural blood patch. Apropos of 2 cases].
Hearing loss and tinnitus are frequently encountered in ENT patients and usually require complementary investigations such as audiogram, auditive evoked potentials, CT scan, MRI... One recent etiology, that is more and more discovered, is a decrease in spinal fluid pressure secondary to a dural fluid leak that occurs after a diagnostic lumbar puncture, a spinal anesthesia, an accidental dural puncture during an epidural technique or a lumbar myelography. Postural headache which are frequently present in such a setting, may mask these auditive symptoms. Epidural injection of autologous blood (blood patch) performed by anesthesiologists, which is usually indicated to treat such postural headaches, is efficient in relieving other symptoms related to spinal fluid leak after dural puncture. We report two cases of isolated auditive complaints (hearing loss and tinnitus) which have been dramatically improved after blood patch. In conclusion, ENT surgeons should seek for a recent or even a past history of spinal puncture whenever the etiology of auditive symptoms of their patient remains unclear.
Viale
M
M
Chirurgie ORL, Clinique Sainte Croix, Le Mans.
Narchi
P
P
Veyrac
P
P
Benhamou
D
D
D000328:Adult; D001299:Audiometry; D017217:Blood Patch, Epidural; D015170:Cerebrospinal Fluid Pressure; D002908:Chronic Disease; D005260:Female; D006312:Hearing Loss, Bilateral / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000209:etiology / Q000628:therapy*