A Case of Unilateral Facial Spasm With Vulnerable Hearing Function Due to a History of Cisplatin Treatment, Resulting in Intraoperative Hearing Loss

TL;DR

A man with a history of cisplatin treatment experienced hearing loss during surgery for facial spasm, highlighting the drug's impact on hearing and the need for careful monitoring.

Contribution

Highlights the risk of intraoperative hearing loss in patients with a history of cisplatin treatment during neurosurgical procedures.

Findings

Cisplatin treatment may cause fragility of the cochlear nerve, increasing the risk of intraoperative hearing loss.

Intraoperative auditory monitoring is crucial for patients with a history of ototoxic drugs like cisplatin.

A minimally invasive approach did not prevent hearing loss in this case due to prior cisplatin-induced damage.

Abstract

A 51-year-old man with a history of cisplatin treatment for a right testicular tumor underwent microvascular decompression for hemifacial spasm. At an early stage in the surgical procedure, the intraoperative auditory brainstem response (ABR) was diminished despite a relatively minimally invasive approach, resulting in irreversible hearing loss. Cisplatin is known to cause dose-dependent hearing impairment primarily affecting the cochlea, but it can also induce neurotoxicity. In the present case, prior cisplatin administration may have caused fragility of the cochlear nerve as well. Patients with a history of ototoxic and neurotoxic drugs such as cisplatin require more careful manipulation and thorough intraoperative auditory monitoring during neurosurgical procedures that may affect hearing, such as those for hemifacial spasms.

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