Facial Nerve and Hearing Issues: Insights on Surgery and Recovery

Facial nerve and hearing issues?

Hello Dr.
Chang, I have been experiencing facial nerve twitching on my right side for nearly three years.
I have continuously seen a neurosurgeon and have been taking Vitamin B and Rivotril 0.5mg for almost two years.
The doctor believes it is not severe and does not recommend surgery.
Later, I decided to seek treatment from a neurosurgeon at National Taiwan University.
After diagnosis, the doctor stated that this is due to vascular compression of the facial nerve, and that surgery is necessary for a complete cure.
The success rate of the surgery is 95%, but there is a 10% chance that my right ear's hearing may be affected (as the facial nerve is adjacent to the vestibulocochlear nerve).
I decided to proceed with the surgery, which was successful, and it has been nearly two months since then.
However, on the seventh day of recovery in the hospital, I lost hearing in my right ear.
I returned to the ENT outpatient clinic twice for hearing tests, and the doctor told me, "This is the price to pay; your eye no longer twitches, but your ear cannot hear." I am currently still within the so-called three-month recovery period.
I would like to ask: 1.
Is there a chance for my right ear's hearing to recover? (Even if it requires the use of a hearing aid) 2.
Can a revision surgery help restore my hearing? 3.
Are there any other methods to improve my right ear's hearing? I would greatly appreciate any guidance you can provide!

Patient Young, 50~59 year old female. Ask Date: 2017/02/24

Dr. Zhang Junwei reply Neurosurgery

I think this should be asked to the surgeon, as only they know whether any nerves were damaged during the procedure.

Reply Date: 2017/02/24

More Info

The situation you are describing involves complex interactions between the facial nerve and the auditory system, particularly after surgical intervention. It is understandable that you have concerns regarding the loss of hearing in your right ear following surgery aimed at addressing facial nerve issues. Let's break down your questions and provide insights based on medical knowledge.

1. Is there a chance for recovery of hearing in the right ear?
Hearing loss following surgery can be a distressing outcome, especially when it occurs shortly after a procedure intended to alleviate other symptoms. The potential for recovery of hearing depends on several factors, including the extent of nerve damage, the type of hearing loss (conductive vs. sensorineural), and the time elapsed since the surgery. In cases of sensorineural hearing loss, which is often associated with nerve damage, recovery is less likely. However, if the hearing loss is conductive (due to obstruction or fluid in the ear), there may be a chance for improvement. Hearing aids can be beneficial in cases where some residual hearing remains, and they can help amplify sounds, making it easier to hear.

2. Can a second surgery restore hearing?
The possibility of a second surgery to restore hearing largely depends on the underlying cause of the hearing loss. If the hearing loss is due to damage to the auditory nerve or inner ear structures, surgical options may be limited. However, if there are other factors contributing to the hearing loss, such as fluid accumulation or structural issues, a surgical intervention may be considered. It is crucial to consult with an otolaryngologist (ENT specialist) who can evaluate your specific case and determine if further surgical intervention is appropriate.

3. Are there other methods to improve hearing in the right ear?
In addition to hearing aids, there are other options that may help improve hearing or manage the symptoms. These include:
- Auditory Rehabilitation: This involves training and strategies to improve communication skills and maximize the use of residual hearing.

- Cochlear Implants: If the hearing loss is profound and not responsive to hearing aids, cochlear implants may be an option. These devices bypass damaged hair cells in the cochlea and directly stimulate the auditory nerve.

- Assistive Listening Devices: These devices can enhance sound in specific situations, such as using a loop system in public places or personal amplifiers.

- Regular Follow-ups: Continuous monitoring and follow-up appointments with your healthcare providers are essential to assess any changes in your hearing and to adjust your management plan accordingly.

In summary, while the loss of hearing following facial nerve surgery can be concerning, there are avenues to explore for potential recovery and management. It is vital to maintain open communication with your healthcare team, including both your neurosurgeon and an ENT specialist, to discuss your symptoms, treatment options, and any new developments in your condition. They can provide personalized recommendations based on your specific situation and help you navigate the recovery process. Remember, each case is unique, and ongoing support is crucial as you work towards improving your quality of life.

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