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Predictive nomogram for hearing deficits after microvascular decompression treatment.

Mingxing Liu1, Xiaoqun Hou1, Feng Chen1

  • 1Department of Neurosurgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), No.1 Jiaozhou Road, Qingdao, Shandong Province, 266011, P.R. China.

Neurosurgical Review
|August 26, 2024
PubMed
Summary
This summary is machine-generated.

This study developed a nomogram to predict hearing deficits after microvascular decompression for hemifacial spasm. The tool uses brainstem auditory evoked potentials and anatomical factors, showing good clinical applicability.

Keywords:
Hearing deficitsHemifacial spasmMicrovascular decompressionNomogram

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Area of Science:

  • Neurosurgery
  • Audiology
  • Medical Imaging

Background:

  • Idiopathic hemifacial spasm (IHS) affects numerous patients, with microvascular decompression (MVD) being a primary treatment.
  • Hearing deficits are a potential complication following MVD, necessitating predictive tools for better patient management.
  • Brainstem auditory evoked potentials (BAEPs) and anatomical characteristics are implicated in auditory function during MVD.

Purpose of the Study:

  • To investigate the impact of BAEP monitoring and anatomical factors on hearing deficits after MVD for IHS.
  • To develop and validate a predictive nomogram for postoperative hearing deficits.

Main Methods:

  • A cohort of 851 patients with IHS undergoing MVD was analyzed.
  • Regression analysis was used to develop a nomogram incorporating BAEPs (wave V change) and anatomical data (retraction depth, duration, and distance).
  • Nomogram performance was assessed using ROC, decision curve, and calibration analyses, with external validation.

Main Results:

  • Patients with hearing deficits showed a higher rate of positive wave V change (71.8%) and exhibited greater retraction depth, duration, and distance.
  • Multivariate logistic regression identified positive wave V change (OR 5.43), greater retraction depth (OR 55.57), and longer retraction duration (OR 1.14) as independent predictors of hearing deficit.
  • The nomogram demonstrated favorable discrimination (AUC 0.88) and reliability in the external validation cohort.

Conclusions:

  • A nomogram integrating wave V change, retraction depth, and retraction duration effectively predicts postoperative hearing deficits in IHS patients undergoing MVD.
  • The developed nomogram shows good clinical applicability and aids in identifying patients at higher risk for hearing impairment.