Sensorineural hearing loss in pregnancy: an alternative, simpler possible explanation.

An interesting paper recently published by Kenny et al. in the Irish Journal of Medical Science reports a case of two episodes of sudden sensorineural hearing loss (SSHL) which occurred to the same patient during two consecutive pregnancies. The possible underlying mechanisms are discussed and include increased endolymphatic pressure linked to changes in CSF pressure associated to a patent cochlear aqueduct, hormone changes, oedema, autoimmune disorders, increased activation of blood coagulation and fibrinolysis during pregnancy. Furthermore, the possibility of an influence of altered anatomy and physiology of the epidural space is taken into account. However, the authors conclude that other possible aetiologies need to be excluded