Hearing Loss after Spinal and General Anesthesia: A Comparative Study

Hearing loss has been described after spinal anesthesia. We examined the hearing in patients before and after spinal and general anesthesia by pure tone audiometry (LdB: 125-1500 Hz; HdB: 2000–8000 Hz). Tympanic membrane displacement analysis was used to noninvasively monitor the intralabyrinthine and intracranial pressure. Eighteen patients received spinal anesthesia (GSA); 19 patients general anesthesia (GGA). Pure tone audiometry and TMD data were obtained preoperatively (0) and postoperatively on day 1 (1) and 2 (2). The mean threshold differences (&Dgr;) in LdB10 and LdB20 were significantly different in GSA compared with GGA (&Dgr;LdB10 + 0.15 ± 3.07 dB vs −1.34 ± 3.77 dB, P = 0.05; &Dgr;LdB20 −0.54 ± 2.24 dB vs −2.45 ± 3.39 dB, P < 0.01). However, there were no differences in &Dgr;HdB10 between GSA and GGA, but in &Dgr;HdB20 (−1.40 ± 3.95 dB vs −5.12 ± 6.35 dB, P = < 0.01). We found a significant correlation between the magnitude of intraoperative intravascular volume replacement and low-frequency hearing loss. Tympanic membrane displacement values were not different pre- and postoperatively. Hearing was impaired after spinal and general anesthesia. Low-frequency hearing loss was correlated with intraoperative volume replacement. Tympanic membrane recordings did not reveal significant changes. Implications The results of this study imply that hearing loss occurs after spinal as well as after general anesthesia. The positive correlation of low-frequency hearing loss and intraoperative fluid administration replacement suggests that cerebrospinal fluid leakage via the spinal puncture hole is not the only factor involved.

[1]  M. Lutman,et al.  Methods for early identification of noise-induced hearing loss. , 1999, Audiology : official organ of the International Society of Audiology.

[2]  D. Baguley.  Intracranial and Inner Ear Physiology and Pathophysiology , 1999, Journal of neurology, neurosurgery, and psychiatry.

[3]  T. Nishida,et al.  [Two cases of hearing disorder following general anesthesia]. , 1999, Masui. The Japanese journal of anesthesiology.

[4]  K. Schorn,et al.  Changes in serum osmolarity influence the function of outer hair cells. , 1999, Acta oto-laryngologica.

[5]  D. Burge,et al.  Quantitative assessment of intracranial pressure by the tympanic membrane displacement audiometric technique in children with shunted hydrocephalus. , 1998, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[6]  A. Walsted.  Effects of cerebrospinal fluid loss on the auditory system. Clinical and experimental investigations. , 1998, Danish medical bulletin.

[7]  R. Marchbanks.  Hydromechanical interactions of the intracranial and intralabyrinthine fluids , 1996 .

[8]  A. Ernst,et al.  Noninvasive assessment of the intralabyrinthine pressure. A new technique applied to patients with X-linked progressive mixed deafness syndrome with perilymphatic gusher during stapes surgery. , 1995, Archives of Otolaryngology - Head and Neck Surgery.

[9]  T. Lenarz,et al.  Die nicht-invasive Beurteilung des intracochleären Druckes - Teil 3: Fallbeispiele von Patienten mit intracochleärer Hyper- und Hypotonie , 1995 .

[10]  T. Lenarz,et al.  [Noninvasive assessment of intracochlear pressure. III. Case reports of patients with intracochlear hyper- and hypotension]. , 1995, Laryngo-Rhino-Otologie.

[11]  T. Lenarz,et al.  [Noninvasive assessment of intracochlear pressure and patency of the cochlear aqueduct in normal probands with TMD (tympanic membrane displacement) analysis]. , 1994, Laryngo-Rhino-Otologie.

[12]  S. Juhn,et al.  Pathophysiology of inner ear fluid imbalance. , 1991, Acta oto-laryngologica. Supplementum.

[13]  K. S. Olsen,et al.  Low-frequency hearing loss after spinal anesthesia. Perilymphatic hypotonia? , 1991, Scandinavian audiology.

[14]  M. Dreyer,et al.  [Transient medium- and deep-tone hearing disorders following spinal anesthesia]. , 1990, Regional-Anaesthesie.

[15]  L. P. Wang,et al.  Hearing Loss After Spinal Anesthesia Is Related to Needle Size , 1990, Anesthesia and analgesia.

[16]  G. Hesse,et al.  [Dehydration therapy in low tone hearing loss. An alternative to rheologic therapy?]. , 1990, HNO (Berlin. Print).

[17]  J. Pickard,et al.  The relationship between intracranial pressure and tympanic membrane displacement. , 1990, British journal of audiology.

[18]  M. Bove,et al.  Transient hearing loss following spinal anaesthesia , 1987, Anaesthesia.

[19]  M. Rosner,et al.  Cerebral perfusion pressure, intracranial pressure, and head elevation. , 1986, Journal of neurosurgery.

[20]  C. Lee,et al.  Unilateral hearing loss after spinal anesthesia treated with epidural blood patch. , 1986, Anesthesia and analgesia.

[21]  L. P. Wang.  Sudden bilateral hearing loss after spinal anaesthesia. A case report , 1986, Acta anaesthesiologica Scandinavica.

[22]  E. Meyer,et al.  The effects of rapid infusions of saline and mannitol on cerebral blood volume and intracranial pressure in dogs , 1985, Canadian Anaesthetists' Society journal.

[23]  E. Lehnhardt,et al.  [Transient low frequency hearing loss following spinal anesthesia]. , 1984, Der Anaesthesist.