I am wondering about any relationship between hearing loss and general anesthesia. Is it possible that turning the head extremely to one side during a middle ear surgery could effect the hearing in the opposite unoperated ear? I have heard of a case where a patient experienced a sudden loss of hearing in the non operated ear, however this took place about 5 or 6 weeks post op. I do not know whether or not this was a coincidence, however this patient was 69 years old and had only a mild high frequency loss before this happened. Are there any tests to determine the possible cause or any references or suggestions you may have. Have you ever heard of neck position during surgery causing problems? I understand my inquiry is anonymous and confidential.
Reply ------------------------------
It depends on the type of hearing loss that is present. If the new hearing loss in the non-operated ear were primarily conductive, then it could be theorized that nasopharyngeal inflammation or simply fluid accumulation due to dependency might have caused the hearing loss. An ear exam and audiometric study would be necessary to confirm this possibility. If confirmed it is likely that it will resolve with time, possibly with the aid of a single course of antibiotics.
On the other hand if the new hearing loss in the non-operated ear is primarily neurosensory, then the only mechanisms I can conceive of that might cause this in the situation you describe would be ototoxicity from an agent used during the operative procedure or a microvascular insult. Micro-vascular insults causing hearing loss have been theorized as a cause of hearing loss occuring acutely in patients having undergone vascular or heart surgery. Possible mechanisms include small clots or micro-emboli or perhaps spasms of the tiny blood vessels supplying the inner ear. Ototoxicity from an anesthetic agent would be unlikely. I also am doubtful that neck position would have any relation to the hearing loss. There really is no specific test that I know of that is likely to be able to definitively determine the etiology of a sudden neurosensory hearing loss thought to have occured during an operative procedure under general anesthesia.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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