Hearing Outcomes Following Ventriculoperitoneal Shunt Placement: A Scoping Review

Background/Objectives: Ventriculoperitoneal shunt (VPS) placement alters cerebrospinal (CSF) dynamics and has been associated with hearing changes through pressure transmission via the cochlear aqueduct. Despite the large number of patients undergoing VPS placement annually, associated hearing changes remain poorly characterized. This scoping review aimed to characterize the available evidence on hearing outcomes following VPS placement and identify gaps warranting further investigation. Methods: This scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed was queried from January 1980 through January 2026. Eligible studies included case reports, case series, and observational cohorts reporting hearing outcomes following VPS placement. Two independent reviewers screened titles, abstracts, and full texts. Risk of bias was assessed using Joanna Briggs critical appraisal tools. Due to heterogeneity in study designs, outcomes metrics, and follow-up duration, quantitative synthesis was not performed. Results: Nineteen studies comprising approximately 200 patients met inclusion criteria. Hearing deterioration and improvement were each reported in 7 studies (36.8%); mixed outcomes were reported in 5 studies (26.3%). Acute hearing changes occurred within 48 h in 3 studies (15.8%), whereas delayed changes were described in 13 studies (68.4%). Overall quality of evidence was low. Conclusions: This scoping review identifies VPS placement as a clinically underrecognized contributor to hearing change. Current evidence is heterogenous and dominated by low level studies, underscoring the need for prospective investigation with standardized audiologic protocols. Preoperative audiograms should be considered when possible, as well as a low threshold for audiology referral for postoperative hearing concerns.