Delayed hearing loss after microvascular decompression for hemifacial spasm

Acta Neurochirurgica (2019) 161:503–508

This study aimed to analyze cases of delayed hearing loss after microvascular decompression (MVD) for hemifacial spasm and identify the characteristic features of these patients.

Methods We retrospectively reviewed the medical records of 3462 patients who underwent MVD for hemifacial spasm between January 1998 and August 2017.

Results Among these, there were 5 cases in which hearing was normal immediately postoperatively but delayed hearing loss occurred. None of the 5 patients reported any hearing disturbance immediately after the operation. However, they developed hearing problems suddenly after some time (median, 22 days; range 10–45 days). On examination, sensorineural hearing loss was confirmed. High-dose corticosteroid treatment was prescribed. Preoperative hearing levels were restored after several months (median duration from the time of the operation, 45 days; range 22–118 days). Interestingly, the inter-peak latency of waves I–III in the brainstem auditory evoked potential (BAEP) was prolonged during the surgery, but recovered within a short time.

Conclusion Delayed hearing loss may occur after MVD for HFS. Prolongation of the inter-peak latency of waves I–III seems to be associated with the occurrence of delayed hearing loss. It is possible that BAEP changes may predict delayed hearing loss, but confirmatory evidence is not available as yet. Analysis of more cases is necessary to determine the utility of BAEP monitoring to predict delayed hearing loss after MVD and to identify its exact cause.