[Inner ear hearing loss following cerebrospinal fluid puncture: a too little appreciated complication?]

Lumbar puncture for myelography, spinal anaesthesia and aspiration of cerebrospinal fluid is a very common procedure. Although it has been known for a long time that hearing impairment may be a late complication, only a few case reports have been published, and not all have included audiograms. We present nine cases of hearing loss following myelography, lumbar puncture and spinal anaesthesia. It appears likely that this rare complication arises only in subjects with a wholly or partially patent cochlear aqueduct, allowing loss of perilymphatic fluid into the cerebrospinal space. Hearing loss was seen in eight of nine patients in the lower frequencies and in six of nine patients on both sides. Hearing recovered in six of nine patients. Transient hearing loss may occur more often than is generally assumed, and the symptom can remain unnoticed. Since not all of these hearing losses proved to be fully reversible, we suggest to inform patients about this complication for medico-legal reasons.