Intra‐operative bilateral otorrhagia during laparoscopic inguinal hernia repair: a case report and review of the literature

Abstract

SummaryAn 81‐year‐old male developed intra‐operative bilateral otorrhagia during a laparoscopic bilateral inguinal hernia repair performed in a steep Trendelenburg position, associated with subcutaneous emphysema. Haemorrhagic blistering was found on both tympanic membranes and in the acoustic meatus, however the tympanic membranes were intact. We believe the combination of a prolonged steep Trendelenburg position, raised intra‐abdominal pressure, hypercarbia due to the pneumoperitoneum and subcutaneous emphysema, was responsible for the bilateral otorrhagia.