The critical warning sign of real-time brainstem auditory evoked potentials during microvascular decompression for hemifacial spasm

Hemifacial spasm (HFS) presents as involuntary, intermittent spasm and is caused by facial nerve compression, secondary to arterial or venous compression at the root exit zone (REZ) (Barker et al., 1995; McLaughlin et al., 1999). Microvascular decompression (MVD) surgery, which involves relieving neurovascular compression, is a widely popular treatment for HFS (Jannetta, 1975; Barker et al., 1995). Since the vestibulocochlear nerve is directly adjacent to the facial nerve, the vestibulocochlear nerve can be damaged during MVD surgery, which could lead to hearing loss (HL) (Barker et al., 1995; Park et al., 2009).

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