Extreme sensitivity of hearing to decreases of ICP in Menière's disease.
We report the case of a Menière's disease patient affected by normal pressure hydrocephalus (NPH) who presented a cerebrospinal fluid (CSF) pressure-dependent hearing impairment after shunting. This side-effect was not only reversible and reproducible but occurred at a high opening pressure when the valve setting was lowered by only 0.7 mmHg (10 mmH(2)O). This observation suggests that hearing in Menière's disease might be very sensitive to small reductions of intracranial pressure (ICP) and that these patients should be informed of this potential risk, which can compromise the efficacy of the shunt.
Kurzbuch
Arthur R
AR
Department of Clinical Neurosciences, Service of Neurosurgery, Geneva University Hospitals and University of Geneva, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Arthur.R.Kurzbuch@hcuge.ch
Momjian
Armen
A
Nicoucar
Keyvan
K
Momjian
Shahan
S
D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D003051:Cochlea / Q000503:physiopathology; D004710:Endolymph / Q000502:physiology; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D012001:Hyperacusis / Q000209:etiology / Q000503:physiopathology*; D019586:Intracranial Hypertension / Q000150:complications / Q000503:physiopathology; D008575:Meniere Disease / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013525:Surgical Instruments / Q000009:adverse effects