Factors for hearing disorder after microvascular decompression for hemifacial spasm

Abstract:

Objective：To investigate the incidence rate of hearing disorder after microvascular decompression（MVD） for hemifacial spasm（HFS） and related factors. Methods：A retrospective analysis was performed for the clinical data of 205 patients who were di－agnosed with HFS and underwent MVD in Department of Neurosurgery，The First Affiliated Hospital of Chongqing Medical University，from January 2015 to January 2018. According to the presence or absence of hearing disorder after surgery，these patients were divided into hearing disorder group and non-hearing disorder group，and related clinical data were compared between these two groups. A multivariate logistic regression analysis was used to identify the risk factors for hearing disorder after surgery. Results：Of all 205 patients，24（11.7%） developed hearing disorder after surgery. The comparison between the two groups showed that intraoperative mastoid incision，physical injury of the acoustic nerve，and vasospasm of the nourishing blood vessels for the acoustic nerve were significantly associated with hearing disorder after surgery（P<0.05）；the multivariate logistic regression analysis showed that intraop－erative mastoid incision（OR=5.495，95%CI＝1.217 to 24.815，P=0.027） and physical injury of the acoustic nerve with vasospasm of the nourishing blood vessels for the acoustic nerve（OR=9.158，95%CI＝1.219 to 68.785，P=0.031） were independent risk factors for hearing disorder after MVD. Conclusion：Mastoid incision during MVD for HFS and physical injury of the acoustic nerve with va－sospasm of the nourishing blood vessels for the acoustic nerve，including the internal auditory artery and the subarcuate artery，are in－dependent risk factors for hearing disorder after MVD. The incidence rate of postoperative hearing disorder can be reduced by avoiding intraoperative mastoid incision，injury of the acoustic nerve，and vasospasm of the nourishing blood vessels for the acoustic nerve.