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Adverse effects of topical papaverine on auditory nerve function
Geraldine M Chadwick1, Anthony L Asher, Craig A Van Der Veer
1Neuroscience and Spine Institute, Carolinas Medical Center, Charlotte, NC, USA. Gerri.Chadwick@Carolinashealthcare.org
Acta Neurochirurgica
|August 30, 2008
Summary
Topical papaverine use during surgery can cause temporary auditory nerve dysfunction, evidenced by brainstem auditory evoked potential (BAEP) changes. This effect is usually reversible, but may lead to hearing loss in some cases.
Area of Science:
- Neurosurgery
- Neurophysiology
- Otolaryngology
Background:
- Papaverine hydrochloride is a vasodilator used in neurosurgery to treat vasospasm.
- Transient cranial nerve dysfunction has been anecdotally reported with topical papaverine use.
- This study investigates the neurophysiological effects of topical papaverine on the auditory nerve.
Observation:
- A retrospective review of 70 microvascular decompression surgeries was conducted.
- Eleven patients received topical papaverine for intraoperative vasospasm.
- Brainstem auditory evoked potentials (BAEPs) were used to monitor auditory nerve function.
Findings:
- Topical papaverine application was temporally associated with complete loss of BAEP waveforms in 10 of 11 patients.
- The average time to BAEP changes after papaverine administration was 5 minutes.
- BAEP waveform recovery averaged 39 minutes, but one patient experienced delayed sensorineural hearing loss.
Implications:
- Topical papaverine may cause transient auditory nerve dysfunction, affecting the proximal eighth nerve.
- The findings suggest a potential risk of cranial nerve deficits with papaverine use.
- Recommendations are provided to mitigate potential papaverine-induced nerve damage during surgery.
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