Permanent hearing loss and tinnitus following epidural analgesia complicated by accidental dural puncture

•Permanent hearing loss and tinnitus is a very rare complication of dural puncture.•Possible causes include altered cochlear physiology due cerebrospinal fluid leak.•High frequency hearing loss is not typical but can be part of the clinical spectrum.•There are no clear evidence-based treatment regim...

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2020-08, Vol.43, p.9-12
Main Authors: O'Shaughnessy, S.M., Fitzgerald, C.W.R., Katiri, R., Kieran, S., Loughrey, J.P.R.
Format: Article
Language:English
Subjects:
Complications
Epidural anaesthesia
Patient safety
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Summary:•Permanent hearing loss and tinnitus is a very rare complication of dural puncture.•Possible causes include altered cochlear physiology due cerebrospinal fluid leak.•High frequency hearing loss is not typical but can be part of the clinical spectrum.•There are no clear evidence-based treatment regimens for this complication.•Clinicians should be aware of this potential complication and its implications. We report a case of permanent high-frequency hearing loss and tinnitus in a 38-year-old woman following an unrecognised dural puncture during epidural placement. The patient reported subjective unilateral hearing loss and tinnitus, along with a post-dural puncture headache, four hours post-delivery. The patient’s headache resolved following two epidural blood patches, however, hearing loss and tinnitus persisted longer than two years. Long-term auditory symptoms following epidural analgesia in labour are very unusual findings.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2020.04.007