Neurotologic Complications Following Microvascular Decompression: A Retrospective Study

Abstract

Microvascular Decompression (MVD) offers effective, long-term symptom relief for patients with pathologies related to neurovascular conflicts of cranial nerves in the posterior fossa. We aimed to determine the frequency of neurotologic complications following this surgery. This is a retrospective case review in a tertiary care referral center. A total of 215 consecutive MVD operations by a single surgeon between March 1996 and May 2016 were reviewed with 192 surgeries on 183 patients meeting inclusion criteria. The 52 males and 131 females had a mean age of 58.52 years (range 28-92 years). Indications for MVD were trigeminal neuralgia (n=162), hemifacial spasm (n=23), glossopharyngeal neuralgia (n=13), vagal palsy (n=1), and tinnitus (n=1). The outcomes examined were postoperative hearing loss, tinnitus, vertigo, and hemifacial paresis. At least one of these complications was present in 17.7% of patients. There were 4.17% with permanent hearing loss, 6.77% with transient hearing loss, 5.21% with tinnitus, 5.73% with vertigo, and 0.52% with hemifacial paresis. There was no significant difference in complication rates based on surgical indication. Complication rates in this study are consistent with those in the literature. We recommend perioperative audiometry in all patients undergoing MVD. It is important for otolaryngologists as well as neurosurgeons to be aware of neurotologic complications in order to adequately counsel patients preoperatively and identify them postoperatively.