hearing loss

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Pain_doc

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Anyone ever had a case of acutely decreased hearing acuity following a lumbar selective nerve injection? A patient called in the day following a L L4 with decreased hearing on the left side. No apparent vascular/intrathecal spread with injection. No immediate complications noted. (Unfortunately, no pain relief either).

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This happened to one of my elderly patients a few years back. The hearing aid had fallen out during the procedure.
 
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it happened to a collegue here. Pt complained of hearing loss after ESI. Was very upset. Pain doc ordered MRI of brain and c spine and ref to neuro. Neuro said everything looked okay but blamed it on the epidural.

Patient is still upset about this unilateral hearing loss. He comes to me for opionion on ESI and hearing loss. I think he was looking to sue and build a case. I notice his left ear has hearing aid but not his right. I said maybe you need to wear a hearing aid on your right ear from now on. He says I already do. and i said no you don't


it had fallen off during the procedure.
 
Slipman published an article on dysphagia or similar as a case series following interventional procedures.

Interesting, but difficult to prove other than the time course.
 
i think that it is a bunch of bull****...but just my opinion
 
I suppose this could happen if there is a dural puncture. Intracranial hypotension can cause hearing deficits. Of course in this case you'd have to posit some very rare things, such as dural puncture during TFESI with a subsequent asymptomatic CSF leak.

Of course, just because A follows B doesn't mean B caused A. I was once accused of causing shingles in the lumbar area a month after an epidural.
 
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