title: Unilateral sensorineural hearing loss after spine surgery: Case report and review of the literature.
abstract: BACKGROUND
  Sudden sensorineural hearing loss is infrequent, with an estimated incidence of 5 to 20 cases yearly per 100,000 people. Although multiple etiologies have been identified, infection and idiopathic SNHL are most common. Sudden sensorineural hearing loss after nonotologic noncardiac surgery is highly unusual, particularly after spinal surgery.
  
  
  METHODS
  We report a case of unilateral sudden SNHL after lumbar spinal fusion with review of the literature. Potential etiologies, treatment, and prognosis are summarized.
  
  
  CONCLUSIONS
  Multiple etiologies have been proposed for SNHL after nonotologic noncardiac surgery. Excessive positive upper airway pressure during induction of anesthesia or Valsalva maneuvers can result in SNHL from LMR. Aberrant NO accumulation in the middle ear cavity during general anesthesia with subsequent LMR is also a potential etiology, as is excessive leakage of CSF causing a form of endolymphatic hydrops. There is no definitive treatment of postoperative SNHL, although middle ear exploration may be beneficial for suspected overpressure injury to the middle ear, causing a perilymphatic fistula. Corticosteroids have been beneficial in certain cases of idiopathic SNHL; however, its effectiveness for postoperative SNHL is undocumented.
authors.affiliation: Department of Neurosurgery, University of Michigan Health System, Ann Arbor, MI 48109, USA. ppark@umich.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Park
authors.forename: James S
authors.initials: JS
authors.lastname: Toung
authors.forename: Paul
authors.initials: P
authors.lastname: Smythe
authors.forename: Steven A
authors.initials: SA
authors.lastname: Telian
authors.forename: Frank
authors.initials: F
authors.lastname: La Marca
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000758:Anesthesia / Q000009:adverse effects; D001299:Audiometry; D019299:Decompression, Surgical / Q000009:adverse effects*; D007758:Ear, Inner / Q000098:blood supply / Q000503:physiopathology; D042241:Early Diagnosis; D007839:Functional Laterality / Q000502:physiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D019586:Intracranial Hypertension / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D007759:Labyrinth Diseases / Q000209:etiology / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013123:Spinal Fusion / Q000009:adverse effects*; D013130:Spinal Stenosis / Q000601:surgery; D014636:Valsalva Maneuver / Q000502:physiology
chemical_list: D000305:Adrenal Cortex Hormones; D009609:Nitrous Oxide