• Ahmed El Damaty, Christian Rosenstengel, Marc Matthes, Joerg Baldauf, Oliver Dziemba, Werner Hosemann, and Schroeder Henry W S HWS Department of Neurosurgery, Greifswald University Medicine, Greifswald, Germany..
• Department of Neurosurgery, Cairo University, Cairo, Egypt.
• Neurosurgery. 2017 Nov 1; 81 (5): 834-843.

BackgroundIntraoperative monitoring of brainstem auditory evoked potentials (BAEPs) has been implemented to reduce the risk of hearing impairment during microvascular decompression for hemifacial spasm.ObjectiveTo evaluate intraoperative monitoring of BAEPs during microvascular decompression in patients with hemifacial spasm for predicting the risk of hearing impairment after surgery.MethodsThis 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.ResultsEighty-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.ConclusionIntraoperative monitoring of BAEPs evaluated through our scoring system was valuable in predicting hearing impairment after surgery.Copyright © 2017 by the Congress of Neurological Surgeons

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