Case Report
Sudden hearing loss following non-petrous craniotomy

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Abstract

We present two patients with known otosclerosis undergoing craniotomy for conditions unrelated to the temporal bone who experienced sudden sensorineural hearing loss. In both patients, the hearing loss was noted immediately post-operatively and there was no subsequent recovery. Sudden hearing loss is a rare complication of non-otologic, non-cardiopulmonary bypass surgery. To our knowledge it has not been described in patients with otosclerosis undergoing craniotomy. This is a rare event that may occur in patients with vulnerable ears, such as those with otosclerosis or pre-existing sensorineural hearing loss.

Introduction

Sudden sensorineural hearing loss is a known complication of otologic surgery. It has also been documented following cardiopulmonary bypass (CPB) surgery, and it is an uncommon complication of other surgical procedures. The literature was reviewed in 1998.1 We performed a further literature search and identified 27 patients who experienced sudden hearing loss related to non-otologic, non-CPB surgery (Table 1).

Here we report a further two patients, both with known otosclerosis who were undergoing craniotomy for conditions unrelated to the temporal bone.

Section snippets

Patient 1

A 49-year-old woman presented acutely with sudden onset of severe headache associated with vomiting. The patient was alert and oriented with no focal neurological deficit. A CT scan with CT angiography demonstrated a subarachnoid haemorrhage from a right posterior communicating artery aneurysm. A smaller aneurysm was found on the left posterior communicating artery. The patient had a past history of bilateral otosclerosis and progressive mixed hearing loss. A left stapedectomy had been

Discussion

Sudden sensorineural hearing loss related to non-otologic surgery was first described by Jaffe in 1967.2 Most cases published since then have reported hearing loss in association with CPB surgery. Proposed mechanisms include microemboli and a localised perfusion deficit related to the low perfusion pressures used in bypass surgery.3 Hearing loss has also been reported in relation to other surgical procedures, the cause of which is not known.

Proposed aetiologies include vascular causes

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