Unilateral permanent sudden sensorineural hearing loss after spina-epidural anaesthesia for caesarean section: a case report

Abstract

Sudden sensorineural hearing loss (SSNHL) after spinal-epidural anaesthesia is a very rare complication. The patient is a 25-year-old female who developed right-sided hearing loss, unbalance, a sensation of aural fullness and tinnitus 2 days post uncomplicated spinal-epidural anaesthesia for an emergency caesarean section. Initial management by her primary care physician for suspected eustachian tube dysfunction did not relieve symptoms, and 2 weeks subsequently, audiological assessment demonstrated right Sensorineural hearing loss (SNHL). Specialist consultation was sought, and the patient was commenced on systemic corticosteroids. Microscope otoscopy and posterior fossa magnetic resonance imaging were normal. High-resolution computed tomography scan demonstrated an enlarged right cochlear aqueduct. Repeat audiology after 2 weeks revealed unchanged hearing levels and improved speech discrimination scores in the right ear (from 53 to 90%). Repeat audiogram at 4 months and at 10 months showed no further improvement. Possible physiopathology of this complication, diagnostic dilemma and review of treatment options are discussed.

Figure 1

Patient’s audiological assessment 2 weeks after symptom onset.

Figure 2

Patient’s CT scan showing an enlarged right cochlear aqueduct.