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Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring

We classified the results of preoperative auditory brainstem response (ABR) in 121 patients with useful hearing and considered the utility of preoperative ABR as a preliminary assessment for intraoperative monitoring. Wave V was confirmed in 113 patients and was not confirmed in 8 patients. Intraope...

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Autores principales: AIHARA, Noritaka, MURAKAMI, Shingo, TAKAHASHI, Mariko, YAMADA, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533473/
https://www.ncbi.nlm.nih.gov/pubmed/24390190
http://dx.doi.org/10.2176/nmc.oa.2013-0258
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author AIHARA, Noritaka
MURAKAMI, Shingo
TAKAHASHI, Mariko
YAMADA, Kazuo
author_facet AIHARA, Noritaka
MURAKAMI, Shingo
TAKAHASHI, Mariko
YAMADA, Kazuo
author_sort AIHARA, Noritaka
collection PubMed
description We classified the results of preoperative auditory brainstem response (ABR) in 121 patients with useful hearing and considered the utility of preoperative ABR as a preliminary assessment for intraoperative monitoring. Wave V was confirmed in 113 patients and was not confirmed in 8 patients. Intraoperative ABR could not detect wave V in these 8 patients. The 8 patients without wave V were classified into two groups (flat and wave I only), and the reason why wave V could not be detected may have differed between the groups. Because high-frequency hearing was impaired in flat patients, an alternative to click stimulation may be more effective. Monitoring cochlear nerve action potential (CNAP) may be useful because CNAP could be detected in 4 of 5 wave I only patients. Useful hearing was preserved after surgery in 1 patient in the flat group and 2 patients in wave I only group. Among patients with wave V, the mean interaural latency difference of wave V was 0.88 ms in Class A (n = 57) and 1.26 ms in Class B (n = 56). Because the latency of wave V is already prolonged before surgery, to estimate delay in wave V latency during surgery probably underestimates cochlear nerve damage. Recording intraoperative ABR is indispensable to avoid cochlear nerve damage and to provide information for surgical decisions. Confirming the condition of ABR before surgery helps to solve certain problems, such as choosing to monitor the interaural latency difference of wave V, CNAP, or alternative sound-evoked ABR.
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spelling pubmed-45334732015-11-05 Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring AIHARA, Noritaka MURAKAMI, Shingo TAKAHASHI, Mariko YAMADA, Kazuo Neurol Med Chir (Tokyo) Original Article We classified the results of preoperative auditory brainstem response (ABR) in 121 patients with useful hearing and considered the utility of preoperative ABR as a preliminary assessment for intraoperative monitoring. Wave V was confirmed in 113 patients and was not confirmed in 8 patients. Intraoperative ABR could not detect wave V in these 8 patients. The 8 patients without wave V were classified into two groups (flat and wave I only), and the reason why wave V could not be detected may have differed between the groups. Because high-frequency hearing was impaired in flat patients, an alternative to click stimulation may be more effective. Monitoring cochlear nerve action potential (CNAP) may be useful because CNAP could be detected in 4 of 5 wave I only patients. Useful hearing was preserved after surgery in 1 patient in the flat group and 2 patients in wave I only group. Among patients with wave V, the mean interaural latency difference of wave V was 0.88 ms in Class A (n = 57) and 1.26 ms in Class B (n = 56). Because the latency of wave V is already prolonged before surgery, to estimate delay in wave V latency during surgery probably underestimates cochlear nerve damage. Recording intraoperative ABR is indispensable to avoid cochlear nerve damage and to provide information for surgical decisions. Confirming the condition of ABR before surgery helps to solve certain problems, such as choosing to monitor the interaural latency difference of wave V, CNAP, or alternative sound-evoked ABR. The Japan Neurosurgical Society 2014-04 2013-12-27 /pmc/articles/PMC4533473/ /pubmed/24390190 http://dx.doi.org/10.2176/nmc.oa.2013-0258 Text en © 2014 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
AIHARA, Noritaka
MURAKAMI, Shingo
TAKAHASHI, Mariko
YAMADA, Kazuo
Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title_full Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title_fullStr Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title_full_unstemmed Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title_short Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring
title_sort preoperative characteristics of auditory brainstem response in acoustic neuroma with useful hearing: importance as a preliminary investigation for intraoperative monitoring
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533473/
https://www.ncbi.nlm.nih.gov/pubmed/24390190
http://dx.doi.org/10.2176/nmc.oa.2013-0258
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