医学
耳鸣
微血管减压术
面肌痉挛
听力损失
入射(几何)
并发症
听力水平
听力学
外科
回顾性队列研究
神经外科
纯音测听
绝对听阈
三叉神经痛
测听
面神经
光学
物理
作者
Masaki Ujihara,Masahito Kobayashi,Satoshi Hirata,Kazuhiko Takabatake,Kenji Wakiya,Takamitsu Fujimaki
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2023-03-28
卷期号:93 (3): 662-669
被引量:3
标识
DOI:10.1227/neu.0000000000002469
摘要
BACKGROUND: Hearing impairment is an important complication of microvascular decompression (MVD). In patients after MVD, we have occasionally noted slight to moderate hearing deterioration at low frequencies that is difficult to detect using pure tone average. OBJECTIVE: To assess the incidence and features of low-frequency hearing impairment (LF-HI) after MVD and evaluate its associated factors. METHODS: This single-center, retrospective observational study assessed the audiometric outcome of 270 patients who underwent MVD between January 2015 and December 2020. Preoperative and postoperative hearing levels were compared for each frequency. LF-HI was defined as a hearing deterioration of ≥15 dB at 125, 250, or 500 Hz. The incidence, symptoms, and associated factors of LF-HI were analyzed. RESULTS: Statistical analysis of the patients overall demonstrated slight but significant decreases in the hearing level after MVD at lower frequencies on both the operative and contralateral sides. Eighty-one patients (30.0%) had LF-HI: 49 on the operative side, 24 on the contralateral side, and 8 on both sides, while pure tone average was worsened in 5 patients (1.8%). Subjective symptoms, including hearing deterioration, ear fullness, tinnitus, and dizziness, developed in 10.4% of the patients with LF-HI but improved subsequently within several weeks. “Older age” and “operative side” were associated with LF-HI. CONCLUSION: Decreases in lower-frequency hearing levels in both the ipsilateral and contralateral (nonoperative) ears were observed after trigeminal neuralgia and hemifacial spasm surgery. LF-HI does not cause permanent symptoms but may be a noteworthy phenomenon, possibly involved in the contralateral hearing loss encountered occasionally after other types of posterior cranial fossa surgery.
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