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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 344-348
DOI: 10.4103/ajns.AJNS_362_19
Original Article

Hearing outcomes after microvascular decompression for hemifacial spasm: An institutional experience

Ambuj Kumar
Department of Neurosurgery, NSCB Government Medical College, Superspeciality Hospital, Jabalpur, Madhya Pradesh
,
Ahmed Ansari
1   Department of Neurosurgery, UPUMS, Etawah, Uttar Pradesh
,
Yasuhiro Yamada
2   Department of Neurosurgery, Fujita Health University Banbuntane Hospital, Nagoya
,
Tsukasa Kawase
2   Department of Neurosurgery, Fujita Health University Banbuntane Hospital, Nagoya
,
Yoko Kato
2   Department of Neurosurgery, Fujita Health University Banbuntane Hospital, Nagoya
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Introduction: Hearing loss following microvascular decompression (MVD) for hemifacial spasm is one of the most dreaded complications. Several factors such as stretching of VIII cranial nerve, vasospasm of labyrinthine artery, and acoustic trauma due to drill noise may be considered in its causation. We evaluated the incidence and severity of hearing loss following MVD in hemifacial spasm and the factors which might be responsible for this complication. Methods: A retrospective analysis of 30 patients operated for hemifacial spasm between January 1, 2014, and December 31, 2018, with at least 3 months of follow-up were included in the study. Retromastoid craniotomy was made, and Teflon was placed between involved vessel and VII nerve. Results: Freedom from hemifacial spasm was noted in 27 of 30 patients. Moderate spasm persisted in one patient, which was controlled with medications. The recurrence was noted in 3 patients at 6 months follow-up. Postoperatively, hearing loss was found in one female patient. The offending vessel was both anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) loop, which was transpositioned during surgery, and the patient was spasm free postoperatively. Conclusion: The incidence of hearing loss following MVD can be minimized using proper surgical techniques and various intraoperative adjuncts such as brainstem auditory evoked responses monitoring, use of endoscope, and indocyanine green or dual-image video angiography.

Key-words:

Hearing loss - microvascular decompression - retromastoid

Financial support and sponsorship

Nil.




Publication History

Received: 15 December 2019

Accepted: 03 January 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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