Department of Neurosurgery, Cairo University, Cairo, Egypt.
Department of Neurosurgery, Greifswald University Medicine, Greifswald, Germany.
Neurosurgery. 2017 Nov 1;81(5):834-843. doi: 10.1093/neuros/nyx111.
Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) has been implemented to reduce the risk of hearing impairment during microvascular decompression for hemifacial spasm.
To evaluate intraoperative monitoring of BAEPs during microvascular decompression in patients with hemifacial spasm for predicting the risk of hearing impairment after surgery.
This prospective study included 100 patients. BAEPs were recorded for all patients. We established a scoring system for the changes in wave I amplitude, I-III interpeak latency, and wave V amplitude and latency. For each change, total points were calculated, and a score out of 6 was assigned to every patient. We classified the patients based on the points scored into 3 risk groups: low-risk (0-3), medium-risk (4-5), and high-risk (6). Further, the correlation between the score and the hearing outcome was evaluated to detect the incidence and degree of hearing impairment.
Eighty-seven patients scored 0 to 3, 10 scored 4 to 5, and 3 scored 6. The degree of hearing impairment was proportionate to the score recorded at the end of surgery, and patients in the low-risk group showed no impairment; medium-risk group, deterioration of maximum 2 grades according to World Health Organization classification of hearing impairment; and high-risk group, deterioration of 3 to 4 grades.
Intraoperative monitoring of BAEPs evaluated through our scoring system was valuable in predicting hearing impairment after surgery.
术中监测脑干听觉诱发电位（BAEPs）已被应用于降低面肌痉挛微血管减压术中听力损伤的风险。
评估术中监测面肌痉挛微血管减压术中的 BAEPs 以预测术后听力损伤的风险。
这是一项前瞻性研究，共纳入 100 例患者。所有患者均记录 BAEPs。我们建立了一个用于评估 I 波振幅、I-III 峰间潜伏期和 V 波振幅和潜伏期变化的评分系统。对于每种变化，计算总积分，并为每位患者分配 6 分制的分数。我们根据得分将患者分为 3 个风险组：低危（0-3 分）、中危（4-5 分）和高危（6 分）。此外，评估评分与听力结果之间的相关性，以检测听力损伤的发生率和程度。
87 例患者得分为 0 至 3 分，10 例患者得分为 4 至 5 分，3 例患者得分为 6 分。听力损伤的程度与手术结束时记录的评分成正比，低危组患者无听力损伤；中危组根据世界卫生组织听力损伤分类恶化最大 2 级；高危组恶化 3 至 4 级。
通过我们的评分系统评估术中 BAEPs 监测对面肌痉挛微血管减压术后听力损伤的预测具有价值。
