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Updated: Nov 21, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
A prewarning sign for hearing loss by brainstem auditory evoked potentials during microvascular decompression surgery
Sang-Ku Park1, Byung-Euk Joo2, John Kwon3
1Department of Neurosurgery, Konkuk University Medical Center, Seoul, Republic of Korea.
Objective:
We aimed to define the prewarning sign of brainstem auditory evoked potentials (BAEPs) associated with cerebellar retraction (CR) during microvascular decompression surgery for hemifacial spasm.
Methods:
A total of 241 patients with a latency prolongation of 1 ms or an amplitude decrement of 50% of wave V were analyzed. According to BAEPs before significant changes during CR, patients were classified into Groups A (latency prolongation of wave I [≥0.5 ms] without prolongation of the I-III interpeak interval [<0.5 ms]) and B (no latency prolongation of wave I [<0.5 ms] with prolongation of the I-III interpeak interval [≥0.5 ms]). BAEPs and postoperative hearing loss (HL) were compared between the two groups.
Results:
Group B comprised 160 (66.4%) patients. With maximal changes in wave V, latency prolongation (≥1 ms) with amplitude decrement (≥50%) was more common in Group B (p < 0.018). At the end of the operation, wave V loss was observed in 11 patients, including 10 patients from Group B. Five patients developed postoperative HL; all were from Group B.
Conclusions:
Latency prolongation of wave III during CR was associated with serious BAEPs changes and postoperative HL.
Significance:
Latency prolongation of wave III is a significant prewarning sign.
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