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

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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.

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