Hearing outcomes following microvascular decompression for hemifacial spasm

Area of Science:

• Neurosurgery
• Audiology
• Otolaryngology

Background:

• Microvascular decompression (MVD) for hemifacial spasm (HFS) is effective but carries risks.
• Hearing loss (HL) is a potential complication due to facial and cochlear nerve proximity.
• Reported incidence of HL after MVD varies significantly in existing literature.

Purpose of the Study:

• To investigate the incidence of hearing loss following MVD for HFS.
• To differentiate between sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) post-MVD.
• To evaluate the predictive value of patient-reported hearing deficits for audiometric outcomes.

Main Methods:

• Retrospective analysis of 151 patients undergoing MVD for HFS.
• Audiometric data including pure tone thresholds and speech discrimination scores were analyzed.
• American Academy of Otolaryngology criteria used to classify post-operative hearing loss.

Main Results:

• 10.6% of patients developed cumulative non-functional hearing loss (Class C and D).
• 18.7% of patients exhibited conductive hearing loss.
• Patient complaints predicted SNHL (Class C/D) with 56.3% sensitivity and 92.6% specificity, but not CHL.

Conclusions:

• Perioperative hearing evaluations are crucial after MVD.
• Combining patient complaints with audiometric testing aids in precise complication rate reporting.
• Distinguishing reversible conductive from permanent sensorineural hearing loss is essential for patient management.