Improvement of chronic hearing loss after shunt revision. A case report.
BACKGROUND
Hearing loss after intracranial and spinal procedures involving cerebrospinal fluid loss is rarely reported in the literature. We report a patient who suffered from delayed hearing loss after cerebrospinal fluid shunting that improved after revising the shunt to a higher-pressure valve.


METHODS
A 32-year-old woman presented with bilateral hearing loss 4 years after ventriculoperitoneal shunting for communicating hydrocephalus. Her otologic work-up revealed sensorineural hearing loss. In an attempt to improve her hearing, 6 years after the hearing loss began (10 years after the shunt was placed), she underwent a shunt revision in which her valve was changed to a higher-pressure device. After the procedure, she had a significant improvement in her speech discrimination and a mild improvement in her pure tone recognition. These changes were documented with serial audiograms.


CONCLUSIONS
Hearing loss after cerebrospinal shunting procedures is not always limited to the immediate postoperative period. It may be a late complication of cerebrospinal fluid diversion. Chronic hearing loss after ventriculoperitoneal shunting may be treatable by changing the valve to a higher-pressure device. The etiology of hearing loss from intracranial hypotension is briefly discussed.
Russell
S M
SM
Department of Neurosurgery, New York University Medical Center, New York University School of Medicine, New York, New York, USA.
Hoffman
R
R
Jafar
J J
JJ
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006312:Hearing Loss, Bilateral / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D011183:Postoperative Complications; D012086:Reoperation; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*