Monitoring Auditory Nerve Potentials during Operations in the Cerebellopontine Angle

1984 ◽  
Vol 92 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Aage R. Øller ◽  
Peter J. Jannetta
Keyword(s):  
Hearing Loss ◽  
Evoked Potentials ◽  
Brain Stem ◽  
Microvascular Decompression ◽  
Auditory Nerve ◽  
Cerebellopontine Angle ◽  
Auditory Evoked Potentials ◽  
Cranial Nerves

Direct monitoring of auditory nerve potentials was performed in 19 patients undergoing retromastoid craniectomy and microvascular decompression of cranial nerves. In addition, brain stem auditory evoked potentials (BSEPs) were monitored in these patients. No patient suffered significant hearing loss. Direct monitoring of auditory nerve potentials complements the recording of BSEPs because the auditory nerve potentials can be visualized without averaging many responses. Therefore the effect of any intraoperative manipulation that is harmful to the auditory nerve can be detected instantaneously.

Delayed and Progressive Hearing Loss after Microvascular Decompression of Cranial Nerves

1996 ◽  
Vol 105 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Takeo Fuse ◽  
Margareta B. Møller
Keyword(s):  
Hearing Loss ◽  
Evoked Potentials ◽  
Brain Stem ◽  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Auditory Evoked Potentials ◽  
Cranial Nerves ◽  
Reflex Response ◽  
Eighth Cranial Nerve ◽  
Progressive Hearing Loss

An unusual case of unilateral delayed and progressive hearing loss following a microvascular decompression operation on cranial nerves V, VII, and VIII on the left side is reported. Preoperative and postoperative audiologic evaluation revealed a mild high-frequency hearing loss for both ears, normal thresholds for the acoustic middle ear reflex response, and normal brain stem auditory evoked potentials. Three years after this microvascular decompression procedure, the patient noticed slowly decreasing hearing in her left ear, and subsequent serial audiograms revealed a progressive sensorineural hearing loss and a decrease in her speech discrimination score. Brain stem auditory evoked potentials showed progressive changes. Because of the patient's increasing symptoms of vertigo and tinnitus in the left ear, reexploration of the eighth cranial nerve was performed 5½ years after the initial procedure. This second operation revealed reactive tissue around the eighth cranial nerve that was atrophic and yellow. We interpret the delayed and progressive hearing loss to be a result of reactive scar tissue and progressive atrophy of the auditory nerve.

Intraoperative monitoring of brain-stem auditory evoked potentials

1982 ◽  
Vol 57 (5) ◽  
pp. 674-681 ◽  
Author(s):  
Betty L. Grundy ◽  
Peter J. Jannetta ◽  
Phyllis T. Procopio ◽  
Agnes Lina ◽  
J. Robert Boston ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Brain Stem ◽  
Auditory Nerve ◽  
Intraoperative Monitoring ◽  
Cerebellopontine Angle ◽  
Auditory Evoked Potentials ◽  
Irreversible Loss ◽  
Content Type ◽  
Complete Obliteration ◽  
Fine Print

✓ Brain-stem auditory evoked potentials (BAEP) were monitored during 54 neurosurgical operations in the cerebellopontine angle. The BAEP were irreversibly obliterated in five patients who required deliberate section of the auditory nerve. Technical difficulties interfered with monitoring in three cases, and three patients had deafness and absent BAEP preoperatively. Reversible alterations in BAEP were seen during 32 operations, with recovery after as long as 177 minutes of virtually complete obliteration. Changes in BAEP were associated with surgical retraction, operative manipulation, positioning of the head and neck for retromastoid craniectomy, and the combination of hypocarbia and moderate hypotension. In 19 cases, waveforms improved after specific interventions made by the surgeon or anesthesiologist because of deteriorating BAEP. In 13 other cases, BAEP recovered after maneuvers not specifically related to the electrophysiological monitoring, most often completion of operative manipulation. Whenever BAEP returned toward normal by the end of anesthesia, even after transient obliteration, hearing was preserved. Irreversible loss of BAEP occurred only when the auditory nerve was deliberately sacrificed. The authors conclude that monitoring of BAEP may help prevent injury to the auditory nerve and brain stem during operations in the cerebellopontine angle.

Does Intraoperative Monitoring of Auditory Evoked Potentials Reduce Incidence of Hearing Loss as a Complication of Microvascular Decompression of Cranial Nerves?

Neurosurgery ◽  
1989 ◽  
Vol 24 (2) ◽  
pp. 257-263 ◽  
Author(s):  
Aage R. Møller ◽  
Margareta B. Møller
Keyword(s):  
Hearing Loss ◽  
Evoked Potentials ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Auditory Evoked Potentials ◽  
Cranial Nerves ◽  
Hearing Threshold ◽  
Speech Discrimination ◽  
Compound Action Potentials

Abstract During a 14-month period, 129 individuals underwent 140 operations for microvascular decompression to relieve hemifacial spasm, disabling positional vertigo, tinnitus, or trigeminal neuralgia at our institution. Seven patients were operated upon twice on the same side and 4 were operated upon on both sides at different times. In each case, the brainstem auditory evoked potentials were monitored intraoperatively by the same neurophysiologist. In 75 of these operations, compound action potentials were also recorded from the exposed 8th nerve. Comparison of speech discrimination scores before the operation and at the time fo discharge showed that at discharge, discrimination had decreased in 7 patients by 15% or more and increased in 4 patients by 15% or more, in 2 patients by as much as 52%. Essentially similar results were obtained when preoperative speech discrimination scores were compared with results obtained from the 87 patients who returned for a follow-up visit between 3 and 6 months after discharge. Only one patient lost hearing (during a second operation to relieve hemifacial spasm). Another patient (also operated upon to relieve hemifacial spasm) suffered noticeable hearing loss postoperatively, but had recovered nearly normal hearing by 4 months after the operation. Nine patients had an average elevation of the hearing threshold for pure tones in the speech frequency range (500 to 2000 Hz) of 11 dB or more at 4 to 5 days after the operation; 8 of these had fluid in their middle ears that most likely contributed to the hearing loss. Threshold elevations occurred at 4000 Hz and 8000 Hz in 19 and 29 ears, respectively.

182. Early detection of hearing loss by means of brain stem auditory evoked potentials

2008 ◽  
Vol 119 (9) ◽  
pp. e144
Author(s):  
E.B. Nuñez ◽  
R.M. Pérez ◽  
M. Amador ◽  
S. Batista
Keyword(s):  
Hearing Loss ◽  
Early Detection ◽  
Evoked Potentials ◽  
Brain Stem ◽  
Auditory Evoked Potentials

scholarly journals Microvascular decompression for typical trigeminal neuralgia: Personal experience with intraoperative neuromonitoring with level-specific-CE-Chirp® brainstem auditory evoked potentials in preventing possible hearing loss

2020 ◽  
Vol 11 ◽  
pp. 388
Author(s):  
Luciano Mastronardi ◽  
Franco Caputi ◽  
Guglielmo Cacciotti ◽  
Carlo Giacobbo Scavo ◽  
Raffaelino Roperto ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Trigeminal Neuralgia ◽  
Evoked Potentials ◽  
Posterior Fossa ◽  
Microvascular Decompression ◽  
Auditory Evoked Potentials ◽  
Intraoperative Neuromonitoring ◽  
Brainstem Auditory Evoked Potentials ◽  
Group A ◽  
Group B

Background: Permanent hearing loss after posterior fossa microvascular decompression (MVD) for typical trigeminal neuralgia (TTN) is one of the possible complications of this procedure. Intraoperative brainstem auditory evoked potentials (BAEPs) are used for monitoring the function of cochlear nerve during cerebellopontine angle (CPA) microsurgery. Level-specific (LS)-CE-Chirp® BAEPs are the most recent evolution of classical click BAEP, performed both in clinical studies and during intraoperative neuromonitoring (IONM) of acoustic pathways during several neurosurgical procedures. Methods: Since February 2016, we routinely use LS-CE-Chirp® BAEPs for monitoring the function of cochlear nerve during CPA surgery, including MVD for trigeminal neuralgia. From September 2011 to December 2018, 71 MVDs for TTN were performed in our department, 47 without IONM of acoustic pathways (Group A), and, from February 2016, 24 with LS-CE-Chirp BAEP (Group B). Results: Two patients of Group A developed a permanent ipsilateral anacusia after MVD. In Group B, we did not observe any permanent acoustic deficit after surgery. In one case of Group B, during arachnoid dissection, intraoperative LS-CE-Chirp BAEP showed a temporary lag of V wave, resolved in 5 min after application of intracisternal diluted papaverine (0.3% solution without excipients). Conclusion: MVD is widely considered a definitive surgical procedure in the management of TTN. Even though posterior fossa MVD is a safe procedure, serious complications might occur. In particular, the use of IONM of acoustic pathways during MVD for TTN might contribute to prevention of postoperative hearing loss.

Appropriate Time to Establish Baseline Responses for Brain stem Auditory Evoked Potentials During Microvascular Decompression for Hemifacial Spasm

2014 ◽  
Vol 31 (5) ◽  
pp. 500-504 ◽  
Author(s):  
Santhosh K. Mohanraj ◽  
Parthasarathy D. Thirumala ◽  
Miguel E. Habeych ◽  
Donald J. Crammond ◽  
Jeffrey R. Balzer
Keyword(s):  
Evoked Potentials ◽  
Brain Stem ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Auditory Evoked Potentials
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