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Intraoperative brainstem auditory evoked potentials

Significant decrease in postoperative morbidity

Divisions of Neurology and Neurosurgery, Duke University Medical Center, Durham, NC.

Evoked potentials are commonly used for intraoperative monitoring of neural tissue under surgical threat despite the lack of unequivocal evidence demonstrating its effectiveness in preventing neural injury. This study retrospectively compares the auditory morbidity of posterior fossa microvascular decompressive surgery before and after the introduction of intraoperative brainstem auditory evoked potentials (BAEPs). All patients underwent a similar operative procedure performed by a single surgeon. The two groups were comparable with regards to age, sex, and indications for surgery. In the nonmonitored group, auditory morbidity had not declined with increasing experience of the surgeon. Ten of 152 patients (6.6%) suffered a profound hearing loss in the nonmonitored group. In the monitored group, none of 70 patients suffered a profound hearing loss. We attribute this significant decline (p = 0.02) in morbidity to the introduction of intraoperative BAEPs. We believe this to be the first demonstration of a significant decrease in operative morbidity directly associated with the use of intraoperative evoked potential monitoring.

Address correspondence and reprint requests to Dr. Radtke, Box 2905, Duke University Medical Center, Durham, NC 27710.

Received March 23, 1988. Accepted for publication in final form August 25, 1988.

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