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Neurosurg Focus ; 34(3): E6, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23451756

RESUMEN

OBJECT: Microvascular decompression (MVD) of the facial nerve is an effective treatment for patients with hemifacial spasm. Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) during MVD can reduce the incidence of hearing loss. In this study the authors' goal was to evaluate changes in interpeak latencies (IPLs) of Waves I-V, Waves III-V, and Waves I-III of BAEP Waveforms I, III, and V during MVD and correlate them with postoperative hearing loss. To date, no such study has been performed. Hearing loss is defined as nonuseful hearing (Class C/D), which is a pure tone average of more than 50 dB and/or speech discrimination score of less than 50%. METHODS: The authors performed a retrospective analysis of IPLs of BAEPs in 93 patients who underwent intraoperative BAEP monitoring during MVD. Patients who did not have hearing loss were in Class A/B and those who had hearing loss were in Class C/D. RESULTS: Binary logistic regression analysis of independent IPL variables was performed. A maximum change in IPLs of Waves I-III and Waves I-V and on-skin change in IPLs of Waves I-V increases the odds of hearing loss. However, on adjusting the same variables for loss of response, change in IPLs did not increase the odds of hearing loss. CONCLUSIONS: Changes in IPL measurements did not increase the odds of postoperative hearing loss. This information might be helpful in evaluating the value of IPLs as alarm criteria during MVD to prevent hearing loss.


Asunto(s)
Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Enfermedades del Nervio Facial/cirugía , Pérdida Auditiva Sensorineural/prevención & control , Espasmo Hemifacial/cirugía , Complicaciones Intraoperatorias/prevención & control , Cirugía para Descompresión Microvascular , Monitoreo Intraoperatorio/métodos , Síndromes de Compresión Nerviosa/cirugía , Traumatismos del Nervio Vestibulococlear/prevención & control , Nervio Vestibulococlear/fisiopatología , Audiometría de Tonos Puros , Electromiografía , Nervio Facial/cirugía , Enfermedades del Nervio Facial/complicaciones , Pérdida Auditiva Sensorineural/diagnóstico , Pérdida Auditiva Sensorineural/epidemiología , Espasmo Hemifacial/etiología , Humanos , Incidencia , Complicaciones Intraoperatorias/diagnóstico , Complicaciones Intraoperatorias/epidemiología , Síndromes de Compresión Nerviosa/complicaciones , Cuidados Posoperatorios , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Tiempo de Reacción , Estudios Retrospectivos , Traumatismos del Nervio Vestibulococlear/diagnóstico , Traumatismos del Nervio Vestibulococlear/epidemiología
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