Complications in retrosigmoid cranial nerve surgery

Conclusions: Although microvascular decompression (MVD), facial nerve splitting (FNS) and neurectomy procedures were safe treatments for hemifacial spasm (HFS), trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GPN) in retrosigmoid cranial nerve surgery, fatal and severe complications may occur. It is essential to pay great attention to the entire procedure to avoid these complications. Objective: To report the complications of cranial nerve surgery via the retrosigmoid approach. Patients and methods: We reviewed 516 cases of cranial nerve surgery via the retrosigmoid approach for HFS, TN and GPN. There were 208 cases of HFS, of which 117 cases underwent FNS alone and 91 cases underwent combined MVD and FNS. There were 273 cases of TN treated by MVD and selective neurectomy. There were 35 cases of GPN treated by neurectomy. Results: Of the cases with complications, two (0.4%) died. Hearing impairment ranging from mild to severe occurred in 31 (6.0%) patients; 4 of these (0.8%) presented total hearing loss. Postoperative cerebrospinal fluid leakage occurred in 29 (5.6%) cases.