Back to Search
Start Over
Relationship between cochleovestibular disorders in hemifacial spasm and neurovascular compression
- Source :
- The Laryngoscope. 109:741-747
- Publication Year :
- 1999
- Publisher :
- Wiley, 1999.
-
Abstract
- Objective: To investigate the evolution of cochleovestibular symptoms before, during, and after microvascular decompression (MVD) of the facial nerve in hemifacial spasm. Study Design: Prospective study in patients with hemifacial spasm. Among our 13 patients who underwent MVD of the facial nerve from 1995 to 1997, 6 had associated cochleovestibular disorders confirmed by neurotologic tests. Results: In four of these patients, a concomitant compression of the eighth and facial nerves was found at surgery. Preoperative magnetic resonance angiography studies had shown three cases of this double neurovascular compression. Intraoperative auditory brainstem response monitoring showed that interposition of Teflon between vessel and facial nerve was highly critical to the auditory function. Auditory brainstem response monitoring was used to guide the surgeon during this critical phase. Surgery improved at least one cochleovestibular symptom in each patient. Conclusions : The authors propose two pathophysiologic hypotheses. First, the concomitant facial and cochleovestibular symptoms may be due to a hyperactivity of both the facial and vestibular nuclei. According to theories about cryptogenic hemifacial spasm, the origin of this hyperactivity could be an ectopic excitation focus. However, the two nerves may have different sites of ectopic excitation. According to the second hypothesis, a pulsatile compression of the facial nerve may be transmitted to the eighth nerve. This could take place even if only the facial nerve is in contact with a vascular loop.
- Subjects :
- Male
medicine.medical_specialty
Cochlear Diseases
medicine.medical_treatment
Microvascular decompression
Magnetic resonance angiography
Postoperative Complications
Vestibular nuclei
Monitoring, Intraoperative
Evoked Potentials, Auditory, Brain Stem
medicine
Humans
Cranial nerve disease
Hemifacial Spasm
Prospective Studies
Aged
medicine.diagnostic_test
business.industry
Middle Aged
Decompression, Surgical
medicine.disease
Magnetic Resonance Imaging
Facial nerve
Surgery
Facial Nerve
stomatognathic diseases
Auditory brainstem response
Vestibular Diseases
Otorhinolaryngology
Vestibule
Female
medicine.symptom
business
Hemifacial spasm
Subjects
Details
- ISSN :
- 15314995 and 0023852X
- Volume :
- 109
- Database :
- OpenAIRE
- Journal :
- The Laryngoscope
- Accession number :
- edsair.doi.dedup.....a4fea0181cfb78b6df5eb7b6ec19e7da