Case: Hearing loss associated with overshunting
C. Hain, MD • Page last modified:
March 7, 2021
see also: csf leaks • Hearing Page
A woman was given a shunt for normal pressure hydrocephalus. Subsequent to this, her hearing dropped precipitiously, and even more so after her neurosurgeon adjusted the valve on her shunt thinking it might improve her gait. After her shunt was turned off, her hearing recovered.
|On the left, hearing with shunt opened up. On the right, hearing with shunt turned off.
This patient's hearing fluctuated according to the functioning of her shunt. We presume that her shunt was "overdraining", causing her hearing to decline. This is similar to the observation of Stoeckli who noted persistent bilateral LTSNHL after shunt placement (1999). A similar case was reported by Miyazaki et al (1997). There is also a small literature about hearing loss associated with spontaneous intracranial hypotension (see references).
These patients have hearing profiles similar to bilateral Meniere's.
- Chen, S., et al. (2012). "Spontaneous intracranial hypotension presenting with severe sensorineural hearing loss and headache." Otol Neurotol 33(8): e65-66.
- Ferrante, E., et al. (2010). "Spontaneous intracranial hypotension syndrome with hearing loss and pachymeningeal enhancement in the internal acoustic canal: neuroimaging correlations." J Craniofac Surg 21(5): 1660-1661.
- Gladstone, J. P. and D. W. Dodick (2005). "Isolated sudden-onset hearing loss as a manifestation of recurrent CSF leak." Cephalalgia 25(7): 550-553.
- Miyazaki, Y., et al. (1997). "[A case of hearing loss caused by overdrainage of cerebrospinal fluid after ventriculo-peritoneal shunting procedure]." No Shinkei Geka 25(4): 367-371.
- Stoeckli, S. J. and A. Bohmer (1999). "Persistent bilateral hearing loss after shunt placement for hydrocephalus. Case report." J Neurosurg 90(4): 773-775.
- Yamada, S., et al. (2013). "[Hearing loss with positional changes due to spontaneous intracranial hypotension improved with treatment; a case report]." Rinsho Shinkeigaku 53(1): 50-53.