Contralateral hearing loss as an effect of venous congestion at the ipsilateral inferior colliculus after microvascular decompression: report of a case. Issue 5 (1st November 2000)

• Record Type: Journal Article
• Authors: Strauss, Christian; Naraghi, Ramin; Bischoff, Barbara; Huk, Walter J; Romstöck, Johann
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 69:Issue 5(2000)
• Page Start: 679
• Page End: 682
• Publication Date: 2000-11-01
• Subjects: auditory pathways -- cerebellopontine angle surgery -- contralateral hearing loss -- microvascular decompression -- superior petrosal vein; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.69.5.679
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Contralateral hearing loss after surgical procedures within the cerebellopontine angle is rarely seen and its pathophysiological background is not yet understood. A patient with contralateral hearing loss after microvascular decompression for trigeminal neuralgia is described. Ipsilateral brainstem auditory potential (BAEP) monitoring and facial nerve EMG did not show major abnormalities. During otherwise uneventful and successful surgery a branch of the petrosal vein was sacrificed to widen the access to the trigeminal root exit zone. On the third postoperative day the patient complained about contralateral hearing loss, which was verified by audiometry. Contralateral BAEPs showed low amplitudes and delayed interpeak latencies. Brain CT was normal. Brain MRI on the 8th postoperative day disclosed abnormal signals within the ipsilateral inferior colliculus. Intravenous heparinisation was performed and hearing slowly recovered over a 3 month period. Results from this patient offer a pathophysiological mechanism for contralateral hearing loss after cerebellopontine angle surgery, illustrate the importance of venous drainage preservation, gives evidence about the generation of BAEP components within the contralateral brainstem, and stresses the importance of intraoperative BAEP monitoring.