J Neurol Surg B Skull Base 2017; 78(01): 043-051
DOI: 10.1055/s-0036-1584557
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Brainstem Auditory Evoked Potentials' Diagnostic Accuracy for Hearing Loss: Systematic Review and Meta-Analysis

Parthasarathy D. Thirumala
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
2   Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Gregory Carnovale
3   Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Yoon Loke
4   Norwich Medical School, University of East Anglia, Norwich, United Kingdom
,
Miguel E. Habeych
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Donald J. Crammond
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Jeffrey R. Balzer
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
3   Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Raymond F. Sekula
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

22 December 2015

03 February 2016

Publication Date:
20 June 2016 (online)

Abstract

Background Microvascular decompression (MVD) utilizes brainstem auditory evoked potential (BAEP) intraoperative monitoring to reduce the risk of iatrogenic hearing loss. Studies report varying efficacy and hearing loss rates during MVD with intraoperative monitoring.

Objectives This study aims to perform a comprehensive review and study of diagnostic accuracy of BAEPs during MVD to predict hearing loss in studies published from January 1984 to December 2013.

Methods The PubMed/MEDLINE and World Science databases were searched. Studies performed MVD for trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia or geniculate neuralgia and monitored intraoperative BAEPs to prevent hearing loss. Retrospectively, BAEP parameters were compared with postoperative hearing. The diagnostic accuracy of significant change in BAEPs, which includes loss of response, was tested using summary receiver operative curve and diagnostic odds ratio (DOR).

Results A total of 13 studies were included in the analysis with a total of 2,540 cases. Loss of response pooled sensitivity, specificity, and DOR with 95% confidence interval being 74% (60–84%), 98% (88–100%), and 69.3 (18.2–263%), respectively. The similar significant change results were 88% (77–94%), 63% (40–81%), and 9.1 (3.9–21.6%).

Conclusion Patients with hearing loss after MVD are more likely to have shown loss of BAEP responses intraoperatively. Loss of responses has high specificity in evaluating hearing loss. Patients undergoing MVD should have BAEP monitoring to prevent hearing loss.

 
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