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Deafness secondary to lumbar puncture
Authors:M Conde  A Villanueva  P Sánchez  JA Pérez  R Ruiz-Rico
Affiliation:Servicio de Otorrinolaringologia, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Espa?a.
Abstract:INTRODUCTION AND OBJECTIVE: Disorders of hearing have been described in patients who have undergone lumbar puncture. The lower frequencies are most affected, temporarily and with spontaneous recovery in most cases. It would seem that the cochlea aqueduct (AC) (an anatomical structure found in the internal ear) is the part involved in the pathogenesis of this infrequent complication. The object of this paper is to review the different hypothesis put forward by various authors on the subject, emphasizing the one which seems most probable. At the same time, we offer a new vision of this little known and often forgotten anatomical structure of the internal ear. The anatomy and physiology of the AC is considered, studying the part played by the labyrinth fluid when the patient undergoes an operation involving the cerebro-spinal fluid (CSF) or the subarachnoid space. CONCLUSIONS: Whenever this technique is to be used, it is essential to obtain a clinical history to find out whether the patient has, or has had, any problems of hearing, and if so of what type. All patients should be warned of the possibility of deafness, in most cases temporary, and if the patient has hydrops endolymphaticus (syndrome of Ménière) of the high risk of worsening his hearing threshold. We therefore recommend precise evaluation of the use of this technique.
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