Abstract

BackgroundTraditionally, tinnitus accompanied by hemifacial spasm has been considered a type of hyperactive neurovascular compression syndrome that is similar to hemifacial spasm alone because of the anatomically close relationship between the facial nerve and cochlear nerve as well as the hyperactive clinical nature.MethodsParticipants were 29 subjects who presented with hemifacial spasm and neuroradiological evidence of vascular compression of the cranial (facial/cochlear) nerve. We used magnetoencephalography (MEG) to estimate the activity of the cochlear nerve in patients with and without tinnitus on the ipsilateral side. We compared the difference in the latency and the ratio of the equivalent current dipole (ECD) strength between the ipsilateral and contralateral sides of the spasm and tinnitus.ResultsCochlear nerve activity in patients with tinnitus was increased with a shorter latency (p = 0.016) and stronger ECD strength (p = 0.028) compared with patients without tinnitus.ConclusionThe MEG results from normal-hearing patients who had tinnitus accompanied by hemifacial spasm suggest that the hyperactivity of the auditory central nervous system may be a crucial pathophysiological factor in the generation of tinnitus in these patients. The neurovascular compression that causes sensory input from the pathologic facial nerve activity may contribute to this hyperactivity of the central auditory nervous system.

Highlights

  • Tinnitus accompanied by hemifacial spasm has been considered a type of hyperactive neurovascular compression syndrome that is similar to hemifacial spasm alone because of the anatomically close relationship between the facial nerve and cochlear nerve as well as the hyperactive clinical nature

  • Due to the anatomically close relationship between the cochlear nerve and the facial nerve, some attempts have been made to perform microvascular decompression to treat tinnitus, based on the assumption that tinnitus is a type of hyperactive neurovascular compression syndrome

  • Tinnitus in 7 of 10 (70%) patients was completely resolved after surgery, which is comparable to the surgical result for hemifacial spasm (HFS) and trigeminal neuralgia [6]

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Summary

Introduction

Tinnitus accompanied by hemifacial spasm has been considered a type of hyperactive neurovascular compression syndrome that is similar to hemifacial spasm alone because of the anatomically close relationship between the facial nerve and cochlear nerve as well as the hyperactive clinical nature. Microvascular decompression surgery has been used to treat tinnitus because neurovascular compression of the cochlear nerve is assumed to be one of the causes of tinnitus. This type of Tinnitus is similar to other neurovascular compression syndromes, such as hemifacial spasm (HFS) and trigeminal neuralgia [2,3,4,5]. Some patients experience ipsilateral tinnitus accompanied by HFS. If tinnitus is accompanied by HFS, the surgical outcome following microvascular decompression has a relatively high success rate, especially in cases in which the cochlear nerve is affected [6,7]. It has been suggested that some forms of tinnitus may be caused by neurovascular compression in the cerebellopontine angle [8,9]

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