Sensorineural listening to loss after backbone surgical procedure handled with hyperbaric oxygen remedy: two case stories.
Undersea Hyperb Med. 2018 Mar-Apr;45(2):217-224
Authors: Goodrich E, Goodrich RP, Reese CA
Acute idiopathic sudden sensorineural listening to loss (ISSNHL) following lumbar spinal surgical procedure is an exceedingly uncommon phenomenon. This paper presents a case of ISSNHL presenting acutely after lumbar backbone decompression and fusion handled with transtympanic steroids and hyperbaric oxygen (HBO?) remedy. It additionally presents the ironic case of SSNHL secondary to presumed viral pathology sustained by the affected person’s operative surgeon who was handled with transtympanic steroids and HBO? as nicely. Proposed etiologies of the affected person’s ISSNHL embody: hypotension, inclined operative place, malfitted/malpositioned headrest, microemboli from a cell-saver, and nitrous oxide anesthesia. The position of systemic hypotension as an etiology of ISSNHL is mentioned given the truth that there are not any reported circumstances of ISSNHL in orthopedic procedures carried out with permissive hypotension. The initiation of steroids and HBO? remedy has been proven to be an efficient therapy for ISSNHL when began inside 14 days of symptom onset. HBO? and transtympanic steroids had been initiated 10 days earlier within the operative surgeon, which confirmed to be a greater therapy modality in comparison with the postoperative affected person. ISSNHL within the acute postoperative interval of lumbar spinal fusion surgical procedure presents a novel therapy dilemma as a result of systemic steroids are routinely averted over considerations of pseudarthrosis. Of the seven documented circumstances of ISSNHL following lumbar backbone surgical procedure, none underwent HBO? as a therapy modality.
PMID: 29734574 [PubMed – in process]