Operative Strategies for Minimizing Hearing Loss and Other Major Complications Associated with Microvascular Decompression for Trigeminal Neuralgia

Auditory Neuropathy Findings Following Microvascular Decompression Surgery for Trigeminal Nerve Neuralgia: A Case Report

“…We attribute the cause to be iatrogenic where the traction of cerebellum during surgical process might have stretched the auditory nerve causing demyelinization or axonal loss of the nerve fibres. Retraction of the cerebellum in lateral direction as in our case can put the auditory nerve on greater stress compared to infero-lateral retraction [2]. Apparently this might have resulted in temporary elevation of low frequency hearing thresholds that were resolved after few days and leaving the cochlear structures intact.…”

Auditory Neuropathy Findings Following Microvascular Decompression Surgery for Trigeminal Nerve Neuralgia: A Case Report

“…We attribute the cause to be iatrogenic where the traction of cerebellum during surgical process might have stretched the auditory nerve causing demyelinization or axonal loss of the nerve fibres. Retraction of the cerebellum in lateral direction as in our case can put the auditory nerve on greater stress compared to infero-lateral retraction [2]. Apparently this might have resulted in temporary elevation of low frequency hearing thresholds that were resolved after few days and leaving the cochlear structures intact.…”

Brainstem Auditory Evoked Potentials' Diagnostic Accuracy for Hearing Loss: Systematic Review and Meta-Analysis

“…8 The hearing evaluation risk of bias was unclear in three studies because no cutoff value in PTA scores or SDS was used to classify HL. 5,18,21 The hearing evaluation risk of bias was high in two studies because they evaluated HL clinically, or did not specify their method. 15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS.…”

“…15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS. 18,21 The hearing evaluation applicability was of high concern in one study because patients subjectively requested auditory tests. 8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies.…”

“…8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies. [15][16][17]21 The high risk was due to three studies that did not include all patients in their analysis and one that did not give a hearing evaluation to all patients.…”

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

“…In our intradural and microsurgical steps, we do not commonly use lumbar catheters or Jannetta's cerebellar retractors for CSF drainage ( 18 , 28 , 29 ). Instead, we rely on microsurgical techniques to open the basolateral cisterns, which we believe sufficiently relaxes the cerebellum reduces the risk of complications associated with lumbar drainage, and allows CSF to naturally drain.…”

Auditory Neuropathy Findings Following Microvascular Decompression Surgery for Trigeminal Nerve Neuralgia: A Case Report

“…We attribute the cause to be iatrogenic where the traction of cerebellum during surgical process might have stretched the auditory nerve causing demyelinization or axonal loss of the nerve fibres. Retraction of the cerebellum in lateral direction as in our case can put the auditory nerve on greater stress compared to infero-lateral retraction [2]. Apparently this might have resulted in temporary elevation of low frequency hearing thresholds that were resolved after few days and leaving the cochlear structures intact.…”

Brainstem Auditory Evoked Potentials' Diagnostic Accuracy for Hearing Loss: Systematic Review and Meta-Analysis

“…8 The hearing evaluation risk of bias was unclear in three studies because no cutoff value in PTA scores or SDS was used to classify HL. 5,18,21 The hearing evaluation risk of bias was high in two studies because they evaluated HL clinically, or did not specify their method. 15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS.…”

“…15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS. 18,21 The hearing evaluation applicability was of high concern in one study because patients subjectively requested auditory tests. 8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies.…”

“…8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies. [15][16][17]21 The high risk was due to three studies that did not include all patients in their analysis and one that did not give a hearing evaluation to all patients.…”

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

“…In our intradural and microsurgical steps, we do not commonly use lumbar catheters or Jannetta's cerebellar retractors for CSF drainage ( 18 , 28 , 29 ). Instead, we rely on microsurgical techniques to open the basolateral cisterns, which we believe sufficiently relaxes the cerebellum reduces the risk of complications associated with lumbar drainage, and allows CSF to naturally drain.…”

Auditory Neuropathy Findings Following Microvascular Decompression Surgery for Trigeminal Nerve Neuralgia: A Case Report

“…We attribute the cause to be iatrogenic where the traction of cerebellum during surgical process might have stretched the auditory nerve causing demyelinization or axonal loss of the nerve fibres. Retraction of the cerebellum in lateral direction as in our case can put the auditory nerve on greater stress compared to infero-lateral retraction [2]. Apparently this might have resulted in temporary elevation of low frequency hearing thresholds that were resolved after few days and leaving the cochlear structures intact.…”

Brainstem Auditory Evoked Potentials' Diagnostic Accuracy for Hearing Loss: Systematic Review and Meta-Analysis

“…8 The hearing evaluation risk of bias was unclear in three studies because no cutoff value in PTA scores or SDS was used to classify HL. 5,18,21 The hearing evaluation risk of bias was high in two studies because they evaluated HL clinically, or did not specify their method. 15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS.…”

“…15,16 The hearing evaluation applicability was unclear in two studies because HL criteria was not reported as PTA or SDS. 18,21 The hearing evaluation applicability was of high concern in one study because patients subjectively requested auditory tests. 8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies.…”

“…8 Flow and timing had an unclear risk in two studies 5,18 and a high risk of bias in four studies. [15][16][17]21 The high risk was due to three studies that did not include all patients in their analysis and one that did not give a hearing evaluation to all patients.…”

The outcomes of microvascular decompression for primary trigeminal neuralgia: insights from a single-center experience and technical advancements

“…In our intradural and microsurgical steps, we do not commonly use lumbar catheters or Jannetta's cerebellar retractors for CSF drainage ( 18 , 28 , 29 ). Instead, we rely on microsurgical techniques to open the basolateral cisterns, which we believe sufficiently relaxes the cerebellum reduces the risk of complications associated with lumbar drainage, and allows CSF to naturally drain.…”