{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:15:24Z","timestamp":1783336524236,"version":"3.54.6"},"reference-count":12,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: To report an unusual case of a bilateral low-frequency air\u2013bone gap consistent with an apparent conductive audiometric pattern following spinal anesthesia and discuss a possible underlying mechanism; Case Presentation: A 56-year-old man underwent elective inguinal hernia repair under spinal anesthesia. On the second postoperative day, he developed a severe postural headache followed by bilateral hearing loss. Otoscopic examination was normal. Tuning fork tests and pure-tone audiometry demonstrated a bilateral low-frequency air\u2013bone gap consistent with an apparent conductive audiometric pattern. Laboratory findings were unremarkable. The patient was managed conservatively with bed rest, hydration and systemic corticosteroids, resulting in gradual clinical improvement; Conclusions: Hearing loss after spinal anesthesia is typically sensorineural and attributed to cerebrospinal fluid pressure alterations. This case highlights a rare apparent conductive audiometric pattern in the absence of clinically evident middle-ear pathology. A possible mechanism may involve altered inner-ear pressure dynamics leading to transient mechanical restriction of stapes mobility. Awareness of this atypical presentation may facilitate prompt recognition and appropriate management.<\/jats:p>","DOI":"10.3390\/reports9030212","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:05:38Z","timestamp":1783325138000},"page":"212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Low-Frequency Air\u2013Bone Gap Following Spinal Anesthesia: An Unusual Audiometric Presentation: Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-1149","authenticated-orcid":false,"given":"Konstantina","family":"Dinaki","sequence":"first","affiliation":[{"name":"Department of ENT Surgery, General Hospital of Mytilene Vostaneio, 81132 Lesvos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7963-9462","authenticated-orcid":false,"given":"Rafail","family":"Ioannidis","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, General Hospital of Drama, 66100 Drama, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, General Hospital of Mytilene Vostaneio, 81132 Lesvos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristidis","family":"Delis","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, General Hospital of Mytilene Vostaneio, 81132 Lesvos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8830-4089","authenticated-orcid":false,"given":"Constantinos","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, General Hospital of Drama, 66100 Drama, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.4236\/ojanes.2012.24039","article-title":"Peri-Operative Hearing Impairment","volume":"2","author":"Singh","year":"2012","journal-title":"Open J. Anesthesiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/IJAM.IJAM_29_21","article-title":"Perioperative hearing loss after nonotological surgeries\u2014What is the role of anesthesia?","volume":"8","author":"Sasidharan","year":"2022","journal-title":"Int. J. Acad. Med."},{"key":"ref_3","first-page":"4295601","article-title":"Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia","volume":"2016","author":"Vilhena","year":"2016","journal-title":"Case Rep. Otolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1017\/S0022215122000226","article-title":"Sensorineural hearing loss following lumbar puncture, spinal anaesthesia or epidural anaesthesia: A case series and literature review","volume":"136","author":"Alwan","year":"2022","journal-title":"J. Laryngol. Otol."},{"key":"ref_5","first-page":"68","article-title":"Isolated bilateral tinnitus after spinal anesthesia: A case report","volume":"36","author":"Arslan","year":"2024","journal-title":"Agriculture"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1016\/j.wneu.2019.07.204","article-title":"Sensorineural Deafness After Spine Surgery: Case Series and Literature Review","volume":"131","author":"Mallepally","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.amsu.2020.10.046","article-title":"Cross-sectional study on hearing loss and auditory reaction time before and after spinal anesthesia with marcaine 0.5% in patients undergoing elective surgery","volume":"60","author":"Vahabi","year":"2020","journal-title":"Ann. Med. 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Otol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1097\/AUD.0000000000001231","article-title":"Low frequency air-bone gap in Meniere\u2019s disease: Relationship with magnetic resonance imaging features of endolymphatic hydrops","volume":"43","author":"Pai","year":"2022","journal-title":"Ear Hear."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1002\/lary.26898","article-title":"The relationship between endolymphatic hydrops in the vestibule and low-frequency air-bone gaps","volume":"128","author":"Sugimoto","year":"2018","journal-title":"Laryngoscope"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/212\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:24:56Z","timestamp":1783333496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,4]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["reports9030212"],"URL":"https:\/\/doi.org\/10.3390\/reports9030212","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,4]]}}}