Neurotologic Complications Following Microvascular Decompression: A Retrospective Study

Objective  The main purpose of this article is to determine the frequency of neurotologic complications after posterior fossa microvascular decompression (MVD) surgery. Design  Retrospective case review. Setting  Tertiary care referral center. Participants  A total of 215 consecutive MVD operations by a single surgeon between March 1996 and May 2016 were reviewed with 192 surgeries on 183 patients meeting inclusion criteria. Main Outcome Measures  Neurotologic complications secondary to MVD. Results  The 52 males and 131 females had a mean age of 58.52 years (range, 28-92 years). Indications for MVD were trigeminal neuralgia ( n  = 162), hemifacial spasm ( n  = 23), glossopharyngeal neuralgia ( n  = 13), vagal palsy ( n  = 1), and tinnitus ( n  = 1). The outcomes examined were postoperative hearing loss, tinnitus, vertigo, and hemifacial paresis. At least one of these complications was present in 17.7% of patients. There were 4.17% with permanent hearing loss, 6.77% with transient hearing loss, 5.21% with tinnitus, 5.73% with vertigo, and 0.52% with hemifacial paresis. There was no significant difference in complication rates based on surgical indication. Conclusions  Neurotologic complications are a significant risk when performing MVD. It is important for otolaryngologists as well as neurosurgeons to be aware of such complications. We recommend perioperative audiometry in all patients undergoing MVD and believe there is utility in routine otolaryngologist involvement.