A Systematic Analysis of the Reliability of Diffusion Tensor Imaging Tractography for Facial Nerve Imaging in Patients with Vestibular Schwannoma

Nolan Ung; Monica Mathur; Lawrance K. Chung; Nicole Cremer; Panayiotis Pelargos; Andrew Frew; Kimberly Thill; Ishani Mathur; Brittany Voth; Michael Lim; Isaac Yang

doi:10.1055/s-0035-1566303

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2016; 77(04): 314-318
DOI: 10.1055/s-0035-1566303

Original Article

Georg Thieme Verlag KG Stuttgart · New York

A Systematic Analysis of the Reliability of Diffusion Tensor Imaging Tractography for Facial Nerve Imaging in Patients with Vestibular Schwannoma

Nolan Ung

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Monica Mathur

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Lawrance K. Chung

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Nicole Cremer

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Panayiotis Pelargos

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Andrew Frew

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Kimberly Thill

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Ishani Mathur

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Brittany Voth

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

,

Michael Lim

³Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

⁴Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

,

Isaac Yang

¹Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States

²Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, United States

› Author Affiliations

Abstract

Surgeons need to visualize the facial nerve reliably in relation to the vestibular schwannoma (VS) in surgical planning. Diffusion tensor imaging (DTI) tractography has enabled unprecedented in vivo preoperative visualization. We collected data to measure the accuracy of DTI for an accurate location of the nerve in preoperative VS resection planning. A PubMed search for relevant studies was conducted. Inclusion criteria were gross total resection of VS, preoperative DTI identification of the facial nerve, and intraoperative cranial nerve localization by the surgeon. Exclusion criteria were tumors other than VS and unsuccessful preoperative location of the cranial nerve. Accuracy rate was calculated by comparing the intraoperative and preoperative locations detailed by DTI. The query identified 38 cases of VS that fit our inclusion criteria. Overall, 89% had surgical findings that agreed with the DTI location of the facial nerve. Of these cases, 32 patients had a postoperative House-Brackmann grade I or II. Our findings suggest that DTI is a reliable method for facial nerve imaging. Implementation of this technique may help decrease facial nerve injury during surgery. Limitations and further studies are needed to better understand what factors correlate with successful location of the facial nerve and DTI in patients with VS.

Keywords

facial nerve - vestibular schwannoma - diffusion tensor imaging tractography

Full Text

References

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