J Neurol Surg B Skull Base 2015; 76(06): 411-415
DOI: 10.1055/s-0034-1390402
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Incidence of Early Postoperative Conductive Hearing Loss after Microvascular Decompression of Hemifacial Spasm

Tingting Ying
1   Department of Neurological Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Parthasarathy Thirumala
2   Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
3   Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Paul Gardner
2   Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Miguel Habeych
2   Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Donald Crammond
2   Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Jeffrey Balzer
2   Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

27. Mai 2014

11. August 2014

Publikationsdatum:
22. Mai 2015 (online)

Abstract

Objectives To evaluate the incidence and discuss the pathogenesis of early postoperative conductive hearing loss (CHL) after microvascular decompression (MVD) for hemifacial spasm (HFS).

Design Pre- and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from patients who had underwent MVD for HFS were analyzed.

Setting The study was conducted at the University of Pittsburgh Medical Center.

Participants MVD for HFS patients who had pre- and postoperative audiogram data, BAEP data, and normal structure of the external and middle ear were included in the study.

Main Outcome Measures CHL was diagnosed if there was an air-bone gap in pure tone audiometry of at least 10 dB at 0.5, 1, 2, or 4 kHz.

Results The incidence of early postoperative CHL in the ipsilateral ear was 18.7% postoperatively. No CHL was observed in the contralateral side. No significant relationship between CHL and intraoperative BAEP changes was found. Demographic parameters were not significantly different between groups with and without CHL.

Conclusions Early postoperative CHL is a significant complication after MVD. Fluid entering the mastoid air cells and/or bone-dust deposition during craniotomy may result in CHL. Long-term audiograms will be needed to evaluate the risk factors that lead to permanent CHL.

 
  • References

  • 1 Jo KW, Kim JW, Kong DS, Hong SH, Park K. The patterns and risk factors of hearing loss following microvascular decompression for hemifacial spasm. Acta Neurochir (Wien) 2011; 153 (5) 1023-1030
  • 2 Park K, Hong SH, Hong SD, Cho YS, Chung WH, Ryu NG. Patterns of hearing loss after microvascular decompression for hemifacial spasm. J Neurol Neurosurg Psychiatry 2009; 80 (10) 1165-1167
  • 3 Polo G, Fischer C, Sindou MP, Marneffe V. Brainstem auditory evoked potential monitoring during microvascular decompression for hemifacial spasm: intraoperative brainstem auditory evoked potential changes and warning values to prevent hearing loss—prospective study in a consecutive series of 84 patients. Neurosurgery 2004; 54 (1) 97-104 ; discussion 104–106
  • 4 Marneffe V, Polo G, Fischer C, Sindou M. Microsurgical vascular decompression for hemifacial spasm. Follow-up over one year, clinical results and prognostic factors. Study of a series of 100 cases. [in French]. Neurochirurgie 2003; 49 (5) 527-535
  • 5 Sindou MP. MP. Microvascular decompression for primary hemifacial spasm. Importance of intraoperative neurophysiological monitoring. Acta Neurochir (Wien) 2005; 147 (10) 1019-1026 ; discussion 1026
  • 6 Stewart MG, Coker NJ, Jenkins HA, Manolidis S, Bautista MH. Outcomes and quality of life in conductive hearing loss. Otolaryngol Head Neck Surg 2000; 123 (5) 527-532
  • 7 Piskorski P, Keefe DH, Simmons JL, Gorga MP. Prediction of conductive hearing loss based on acoustic ear-canal response using a multivariate clinical decision theory. J Acoust Soc Am 1999; 105 (3) 1749-1764
  • 8 Doménech J, Carulla M, Traserra J. Sensorineural high-frequency hearing loss after drill-generated acoustic trauma in tympanoplasty. Arch Otorhinolaryngol 1989; 246 (5) 280-282
  • 9 Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995; 113 (3) 179-180
  • 10 Hatayama T, Møller AR. MA. Correlation between latency and amplitude of peak V in the brainstem auditory evoked potentials: intraoperative recordings in microvascular decompression operations. Acta Neurochir (Wien) 1998; 140 (7) 681-687
  • 11 Thirumala PD, Kassasm AB, Habeych M , et al. Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes. Neurosurgery 2011; 69 (1, Suppl Operative): ons64-ons76 ; discussion ons76
  • 12 Murai K, Kon Y, Obara Y, Tsuiki T, Kawashima H, Saiki I. A study on auditory disturbances after microvascular decompression for hemifacial spasm. [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho 1991; 94 (5) 657-666
  • 13 Brooks RC, Graham MD. Postoperative accumulation of bone in the middle ear: effect on hearing and surgical implications. Am J Otol 1980; 2 (2) 168-169
  • 14 Devesa PM, Michaels L, Wright A. Ossicular fixation caused by bone dust after saccus decompression surgery. Otol Neurotol 2002; 23 (6) 949-951 ; discussion 951–952
  • 15 Ravicz ME, Rosowski JJ, Merchant SN. Mechanisms of hearing loss resulting from middle-ear fluid. Hear Res 2004; 195 (1–2) 103-130
  • 16 Moller AR. Intraoperative Neurophysiological Monitoring. 3rd ed. New York, NY: Springer; 2011: 154
  • 17 Ferguson MO, Cook RD, Hall III JW, Grose JH, Pillsbury III HC. Chronic conductive hearing loss in adults: effects on the auditory brainstem response and masking-level difference. Arch Otolaryngol Head Neck Surg 1998; 124 (6) 678-685
  • 18 Gerull G, Giesen M, Mrowinski D. Simulating middle ear function for surgery. Brainstem audiometry during tympanoplasty. Clin Otolaryngol Allied Sci 1978; 3 (4) 503-506
  • 19 Mutlu C, Tekin M, Paparella MM, Schachern PA. Bone dust in the middle ear. Am J Otol 2000; 21 (2) 286-287
  • 20 Parikh AA, Brookes GB. Conductive hearing loss following retrolabyrinthine surgery. Arch Otolaryngol Head Neck Surg 1996; 122 (8) 841-843
  • 21 Belal Jr A, House WF. Histopathology of endolymphatic subarachnoid shunt surgery for Meniere's disease. Am J Otol 1979; 1 (1) 37-44