Delayed and progressive hearing loss after microvascular decompression of cranial nerves

Author(s): Moller, M. B.

Journal/Book: Ann Otol Rhinol Laryngol. 1996; 105: 4507 Laclede Ave, St Louis, MO 63108. Annals Publ Co. 158-161.

Abstract: 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 5 1/2 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.

Note: Article T Fuse, Yamagata Univ, Sch Med, Dept Otorhinolaryngol, 2-2-2 Iida Nishi, Yamagata 99023, Japan

Keyword(s): brain stem auditory evoked potentials; microvascular decompression; progressive hearing loss; DISABLING POSITIONAL VERTIGO; HEMIFACIAL SPASM; NEUROVASCULAR DECOMPRESSION

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