Delayed hearing loss after surgery for acoustic neurinomas : clinical and electrophysiological observations
In a series of 26 patients with medium-sized and large acoustic neurinomas and documented hearing before surgery, 7 patients had preservation of hearing initially after the procedure but then developed delayed hearing loss. The most prominent intraoperative electrophysiological finding in these case...
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| Veröffentlicht in: | Neurosurgery 1991-04, Vol.28 (4), p.559-565 |
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| container_title | Neurosurgery |
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| creator | STRAUSS, C FAHLBUSCH, R ROMSTOÊCK, J SCHRAMM, J WATANABE, E TANIGUCHI, M BERG, M |
| description | In a series of 26 patients with medium-sized and large acoustic neurinomas and documented hearing before surgery, 7 patients had preservation of hearing initially after the procedure but then developed delayed hearing loss. The most prominent intraoperative electrophysiological finding in these cases was a gradual deterioration of brain stem auditory evoked potentials (BAEP), especially of Wave V. Four additional patients with a similar gradual intraoperative loss of BAEP and severe postoperative hearing deterioration received vasoactive treatment after surgery (low-molecular weight dextran). In all 4 patients, including 1 patient with documented total deafness after surgery, hearing was preserved. Initial preservation of cochlear nerve function after the removal of an acoustic neurinoma does not guarantee postoperative hearing. Intraoperative BAEP help to identify patients at risk for delayed postoperative hearing loss. The pathophysiological mechanism can be attributed to disturbances of the microcirculation in endoneurial vasa nervorum caused by the mechanical manipulation of the cochlear nerve. |
| doi_str_mv | 10.1227/00006123-199104000-00012 |
| format | Article |
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The most prominent intraoperative electrophysiological finding in these cases was a gradual deterioration of brain stem auditory evoked potentials (BAEP), especially of Wave V. Four additional patients with a similar gradual intraoperative loss of BAEP and severe postoperative hearing deterioration received vasoactive treatment after surgery (low-molecular weight dextran). In all 4 patients, including 1 patient with documented total deafness after surgery, hearing was preserved. Initial preservation of cochlear nerve function after the removal of an acoustic neurinoma does not guarantee postoperative hearing. Intraoperative BAEP help to identify patients at risk for delayed postoperative hearing loss. The pathophysiological mechanism can be attributed to disturbances of the microcirculation in endoneurial vasa nervorum caused by the mechanical manipulation of the cochlear nerve.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/00006123-199104000-00012</identifier><identifier>PMID: 1709726</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Audiometry, Pure-Tone ; Biological and medical sciences ; Brain Stem - physiopathology ; Cranial nerves. Peripheral nerves. Autonomic nervous system ; Deafness - diagnosis ; Deafness - etiology ; Dextrans - therapeutic use ; Evoked Potentials, Auditory - physiology ; Female ; Hearing Loss - diagnosis ; Hearing Loss - drug therapy ; Hearing Loss - etiology ; Humans ; Male ; Medical sciences ; Middle Aged ; Neuroma, Acoustic - surgery ; Neurosurgery ; Postoperative Complications - etiology ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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The most prominent intraoperative electrophysiological finding in these cases was a gradual deterioration of brain stem auditory evoked potentials (BAEP), especially of Wave V. Four additional patients with a similar gradual intraoperative loss of BAEP and severe postoperative hearing deterioration received vasoactive treatment after surgery (low-molecular weight dextran). In all 4 patients, including 1 patient with documented total deafness after surgery, hearing was preserved. Initial preservation of cochlear nerve function after the removal of an acoustic neurinoma does not guarantee postoperative hearing. Intraoperative BAEP help to identify patients at risk for delayed postoperative hearing loss. The pathophysiological mechanism can be attributed to disturbances of the microcirculation in endoneurial vasa nervorum caused by the mechanical manipulation of the cochlear nerve.</description><subject>Adult</subject><subject>Aged</subject><subject>Audiometry, Pure-Tone</subject><subject>Biological and medical sciences</subject><subject>Brain Stem - physiopathology</subject><subject>Cranial nerves. Peripheral nerves. Autonomic nervous system</subject><subject>Deafness - diagnosis</subject><subject>Deafness - etiology</subject><subject>Dextrans - therapeutic use</subject><subject>Evoked Potentials, Auditory - physiology</subject><subject>Female</subject><subject>Hearing Loss - diagnosis</subject><subject>Hearing Loss - drug therapy</subject><subject>Hearing Loss - etiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Neurosurgery</subject><subject>Postoperative Complications - etiology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Peripheral nerves. Autonomic nervous system</topic><topic>Deafness - diagnosis</topic><topic>Deafness - etiology</topic><topic>Dextrans - therapeutic use</topic><topic>Evoked Potentials, Auditory - physiology</topic><topic>Female</topic><topic>Hearing Loss - diagnosis</topic><topic>Hearing Loss - drug therapy</topic><topic>Hearing Loss - etiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuroma, Acoustic - surgery</topic><topic>Neurosurgery</topic><topic>Postoperative Complications - etiology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STRAUSS, C</creatorcontrib><creatorcontrib>FAHLBUSCH, R</creatorcontrib><creatorcontrib>ROMSTOÊCK, J</creatorcontrib><creatorcontrib>SCHRAMM, J</creatorcontrib><creatorcontrib>WATANABE, E</creatorcontrib><creatorcontrib>TANIGUCHI, M</creatorcontrib><creatorcontrib>BERG, M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STRAUSS, C</au><au>FAHLBUSCH, R</au><au>ROMSTOÊCK, J</au><au>SCHRAMM, J</au><au>WATANABE, E</au><au>TANIGUCHI, M</au><au>BERG, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delayed hearing loss after surgery for acoustic neurinomas : clinical and electrophysiological observations</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>1991-04-01</date><risdate>1991</risdate><volume>28</volume><issue>4</issue><spage>559</spage><epage>565</epage><pages>559-565</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>In a series of 26 patients with medium-sized and large acoustic neurinomas and documented hearing before surgery, 7 patients had preservation of hearing initially after the procedure but then developed delayed hearing loss. The most prominent intraoperative electrophysiological finding in these cases was a gradual deterioration of brain stem auditory evoked potentials (BAEP), especially of Wave V. Four additional patients with a similar gradual intraoperative loss of BAEP and severe postoperative hearing deterioration received vasoactive treatment after surgery (low-molecular weight dextran). In all 4 patients, including 1 patient with documented total deafness after surgery, hearing was preserved. Initial preservation of cochlear nerve function after the removal of an acoustic neurinoma does not guarantee postoperative hearing. Intraoperative BAEP help to identify patients at risk for delayed postoperative hearing loss. The pathophysiological mechanism can be attributed to disturbances of the microcirculation in endoneurial vasa nervorum caused by the mechanical manipulation of the cochlear nerve.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>1709726</pmid><doi>10.1227/00006123-199104000-00012</doi><tpages>7</tpages></addata></record> |
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| ispartof | Neurosurgery, 1991-04, Vol.28 (4), p.559-565 |
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| language | eng |
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| subjects | Adult Aged Audiometry, Pure-Tone Biological and medical sciences Brain Stem - physiopathology Cranial nerves. Peripheral nerves. Autonomic nervous system Deafness - diagnosis Deafness - etiology Dextrans - therapeutic use Evoked Potentials, Auditory - physiology Female Hearing Loss - diagnosis Hearing Loss - drug therapy Hearing Loss - etiology Humans Male Medical sciences Middle Aged Neuroma, Acoustic - surgery Neurosurgery Postoperative Complications - etiology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Time Factors |
| title | Delayed hearing loss after surgery for acoustic neurinomas : clinical and electrophysiological observations |
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