Microvascular decompression of cochleovestibular nerve

Yap, L.; Pothula, Vijay; Lesser, T. H. J.

doi:10.1007/s00405-008-0647-3

Cited by 37 publications

(37 citation statements)

References 58 publications

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“…T2-VISTA imaging of the IAC and CPA was performed with the following parameters: FOV, 160 ϫ 160 mm 2 …”

Section: Mr Imaging Protocolmentioning

confidence: 99%

“…[1][2][3][4] Among these clinical symptoms, typewriter tinnitus, which was first described by a pediatric cardiologist as "ear-clicking tinnitus responding to carbamazepine," 5 is characterized by paroxysmal attacks. It is either spontaneous or precipitated by positioning or sounds and occurs with staccato sounds described as "Morse code," "machine gun," "coins in a can," "crackling," or "typewriter" sounds.…”

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confidence: 99%

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The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus

Bae¹,

Jeon

Choi³

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Typewriter tinnitus, a symptom characterized by paroxysmal attacks of staccato sounds, has been thought to be caused by neurovascular compression of the cochlear nerve, but the correlation between radiologic evidence of neurovascular compression of the cochlear nerve and symptom presentation has not been thoroughly investigated. The purpose of this study was to examine whether radiologic evidence of neurovascular compression of the cochlear nerve is pathognomonic in typewriter tinnitus.

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“…T2-VISTA imaging of the IAC and CPA was performed with the following parameters: FOV, 160 ϫ 160 mm 2 …”

Section: Mr Imaging Protocolmentioning

confidence: 99%

mentioning

confidence: 99%

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus

Bae¹,

Jeon

Choi³

et al. 2017

AJNR Am J Neuroradiol

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“…The timing of surgery for CNVC with chief complaint of tinnitus should be limited as some reports. Significant improvements in the intensity of tinnitus were achieved in some patients with symptoms for less than 2 years, as described by Sakaki et al [5], Bookes [9], and Yap et al [13], and in those with symptoms for between 2 and 4 years, as found by Sakaki et al [5] and Ryu et al [10]. Significant improvements [10,14] in tinnitus has been reported even in patients persisting 4-6 years.…”

Section: Discussionmentioning

confidence: 70%

“…Several diagnostic processes [4,[7][8]12,13] related to the features of CNVC have been reported: recurrent vertigo, intractable tinnitus, and the progressive hearing loss. Neuro-otological examinations involving vestibular testing and an ABR evaluation [2,8] are very important.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding vertigo, the study by Jannetta et al [2] on DVP is historical. There are several reports on the surgical results microvascular decompression (MVD) [3][4][5][6][7][8][9][10][11][12][13] for CNVC; however, surgical indications remain controversial. Therefore, the aim of the present study is to clarify surgical indications and the timing of surgery for CNVC.…”

Section: Introductionmentioning

confidence: 99%

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Indication and Timing of Surgery for Cochleovestibular Neurovascular Compression Syndrome

Okamura¹,

Takafumi²,

Ikeda³

et al. 2017

J Phonet and Audiol

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Objective: Optimal surgical indications for cochleovestibular neurovascular compression syndrome (CNVC) remain controversial. We examined the surgical indications and timing of surgery for CNVC. Methods: The surgical outcomes of 30 patients (32 sides) with vertigo, tinnitus and hearing loss were evaluated. CNVC was diagnosed according to five items for clinical features with a scoring system of 1 or 0 based on the following features: a history, neurological and otological findings, an ABR evaluation, and vascular contact with the eighth cranial nerve on MR or air CT imaging. Patients with scores of 4-5 were diagnosed with CNVC. In addition, three modulation types of tinnitus using median nerve stimulation were evaluated in CNVC (28 sides) and other diseases (12 sides), and classified as suppression (S-type), no change (N-type), and excitation (E-type). Results: At early time, results of 16 sides evaluated using the modulation test before surgery for CNVC, the relationship between modulation of tinnitus and surgical results was evaluated. The ratio of the tinnitus intensity early after the surgery to that before the surgery was significantly lower for the S-type than for the other two types (P<0.01). At one year follow-up, the results of 32 sides were excellent in 8 sides, good in 19 sides, fair in 2 sides and poor in 3 sides. The duration of preoperative symptoms in the excellent group (1.9 ± 6.7 years) was shorter than that in the good group (5.8 ± 5.8 years). Results of CNVC with a chief complaint of vertigo and the duration of symptoms over 15 years and CNVC with a chief complaint of tinnitus and the duration of symptoms over 3 years was not always satisfactory. Conclusion: Indications for good outcomes are limited and need to consider not only the duration of symptoms, but also the modulation of tinnitus. Our findings suggest that the timing of surgery for CNVC with a complaint of vertigo should be within about 15 years, but that for CNVC with tinnitus should be within 3 years of onset of symptoms. Furthermore, some patients with S-type of less than 6 years are good candidates for surgery.

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The association between auditory nerve neurovascular conflict and sudden unilateral sensorineural hearing loss

Ungar

Brenner‐Ullman

Cavel

et al. 2018

Laryngoscope Investig Oto

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HypothesisThere may be an association between a neurovascular conflict (NVC) of the auditory nerve and unilateral sudden sensorineural hearing loss (SSNHL).BackgroundCompression of cranial nerves by vascular structures can lead to significant symptomatology that may require surgical decompression. Notable examples are trigeminal neuralgia and hemifacial spasm. Magnetic resonance imaging (MRI) is part of the workup for SSNHL, and it may depict an NVC of the auditory nerve. Here we look into the association between this NVC and unilateral SSNHL.MethodsA retrospective analysis was performed on all consecutive patients with unilateral SSNHL who underwent an MRI scan in our medical center. The data collected included age, gender, side and severity of hearing loss, and accompanying complaints. Each MRI scan was reviewed by a neuroradiologist who was unaware of hearing loss laterality. The presence, side, extent, and location of a potential NVC involving the auditory nerve were determined, and a correlation between radiological findings and auditory parameters was sought.ResultsFifty‐four patients (male‐to‐female ratio 26:28, age range 25–80 years) were enrolled into the study. Fourteen of them (25.9%) had normal MRI findings. Twenty‐six patients had a unilateral NVC, and the pathology was ipsilateral to the side of hearing loss in only 12 of them (46.2%). Fourteen (25.9%) patients had MRI findings of bilateral NVCs. There was no significant correlation between the side of the SSNHL and any radiological findings (P = .314).ConclusionThe data presented herein support the conclusion that there is no association between CN8 NVC and unilateral SSNHL.Level of Evidence2b.

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Microvascular decompression of cochleovestibular nerve

Cited by 37 publications

References 58 publications

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus

Indication and Timing of Surgery for Cochleovestibular Neurovascular Compression Syndrome

The association between auditory nerve neurovascular conflict and sudden unilateral sensorineural hearing loss

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