Hearing Loss following Posterior Fossa Microvascular Decompression: A Systematic Review

Area of Science:

• Neurosurgery
• Audiology
• Otolaryngology

Background:

• Microvascular decompression (MVD) is a surgical treatment for trigeminal neuralgia (TN) and hemifacial spasm (HFS).
• Hearing loss is a potential complication of MVD, but its prevalence and influencing factors require further clarification.

Purpose of the Study:

• To determine the prevalence of hearing loss after MVD for TN and HFS.
• To identify factors affecting postoperative hearing outcomes in patients undergoing MVD.

Main Methods:

• Systematic review of prospective cohort studies and retrospective reviews published between 1981 and 2016.
• Data extraction from 69 references encompassing 18,233 MVD operations for TN and HFS.
• Analysis of studies with consistent perioperative audiograms and intraoperative monitoring.

Main Results:

• Overall reported hearing loss prevalence was 5.58% for TN and 8.25% for HFS, often based on subjective reporting.
• In studies with objective audiograms, hearing loss prevalence was 13.47% for TN and 13.39% for HFS.
• Intraoperative brainstem auditory evoked potential monitoring increased reported hearing loss for TN but not HFS.

Conclusions:

• Conductive and sensorineural hearing loss are significant complications of posterior fossa MVD.
• Inconsistent audiometric testing and subjective reporting limit accurate prevalence assessment.
• Routine perioperative audiograms are recommended for precise detection of hearing loss post-MVD.