• Rafael Martinez-Perez, Agustin Montivero, Natalia Rayo, Marco Ramirez, Cristian Naudy, and Jorge Mura.
• Division of Skull Base and Vascular Neurosurgery, National Institute of Neurosurgery Dr Asenjo, Universidad de Chile, Santiago, Chile; Department of Neurosurgery, Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain. Electronic address: rafa11safin@hotmail.com.
• World Neurosurg. 2018 May 1; 113: 276-279.

BackgroundMild hearing loss following shunting has been described; however, severe auditory impairment associated with ventriculoperitoneal (VP) shunt is an uncommon, rarely reported phenomenon. Treatment options and pathophysiologic considerations are discussed in this case report.Case DescriptionA 27-year-old man who was treated for an eighth cranial nerve schwannoma with complete resection and a VP shunt 10 years previously presented to the emergency department with acute severe hearing loss and headache. Imaging showed diminished size of the ventricles and dural contrast enhancement. The previous shunt was replaced with a programmable antisiphoning VP shunt. The patient's hearing and headache improved 48 hours later, as demonstrated in serial audiograms.ConclusionsHearing loss is an underestimated complication of shunting that in some cases may progress to severe impairment and deafness. Patients with a VP shunt who experience hearing loss should undergo further evaluation and possibly adjustment of shunt settings.Copyright © 2018 Elsevier Inc. All rights reserved.

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