Predicting Shape, Location, and Course of Facial Nerve in Relation to Large Vestibular Schwannoma on Diffusion Tensor Imaging with Intraoperative Correlation: Important Surgical Adjunct

2017 ◽  
Vol 105 ◽  
pp. 1002 ◽  
Author(s):  
Guru Dutta Satyarthee
Keyword(s):  
Diffusion Tensor Imaging ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Diffusion Tensor ◽  
Surgical Adjunct ◽  
Large Vestibular Schwannoma

scholarly journals Dorsal displacement of the facial nerve in vestibular schwannoma surgery

2021 ◽  
Vol 5 (2) ◽  
pp. V9
Author(s):  
Gustavo S. Jung ◽  
Joel Fernando Sanabria Duarte ◽  
Afonso H. de Aragão ◽  
Ronaldo Pereira Vosgerau ◽  
Ricardo Ramina
Keyword(s):  
Diffusion Tensor Imaging ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Diffusion Tensor ◽  
Fiber Tracking ◽  
Vestibular Schwannomas ◽  
Tumor Capsule ◽  
Link Type ◽  
Risk Of Injury ◽  
Diffusion Tensor Imaging Dti

The course of the facial nerve (FN) has been extensively investigated in patients with vestibular schwannomas (VSs). FN running dorsally to the tumor capsule accounts for less than 3% of the cases. Diffusion tensor imaging (DTI)–based fiber tracking helps to preoperatively identify the FN. During surgery, a higher risk of injury is associated with the dorsal location of the FN. The authors demonstrate the nuances and tricks to identify and preserve a dorsal displaced FN during resection of a large VS, T3b according to the Hannover classification, through the retrosigmoid-transmeatal approach. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2182

scholarly journals Preoperative diffusion tensor imaging–fiber tracking for facial nerve identification in vestibular schwannoma: a systematic review on its evolution and current status with a pooled data analysis of surgical concordance rates

2018 ◽  
Vol 44 (3) ◽  
pp. E5 ◽  
Author(s):  
Amey R. Savardekar ◽  
Devi P. Patra ◽  
Jai D. Thakur ◽  
Vinayak Narayan ◽  
Nasser Mohammed ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diffusion Tensor Imaging ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Diffusion Tensor ◽  
Fiber Tracking ◽  
Pooled Analysis ◽  
Current Status ◽  
Cochrane Library ◽  
Female Ratio

OBJECTIVETotal tumor excision with the preservation of neurological function and quality of life is the goal of modern-day vestibular schwannoma (VS) surgery. Postoperative facial nerve (FN) paralysis is a devastating complication of VS surgery. Determining the course of the FN in relation to a VS preoperatively is invaluable to the neurosurgeon and is likely to enhance surgical safety with respect to FN function. Diffusion tensor imaging–fiber tracking (DTI-FT) technology is slowly gaining traction as a viable tool for preoperative FN visualization in patients with VS.METHODSA systematic review of the literature in the PubMed, Cochrane Library, and Web of Science databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and those studies that preoperatively localized the FN in relation to a VS using the DTI-FT technique and verified those preoperative FN tracking results by using microscopic observation and electrophysiological monitoring during microsurgery were included. A pooled analysis of studies was performed to calculate the surgical concordance rate (accuracy) of DTI-FT technology for FN localization.RESULTSFourteen studies included 234 VS patients (male/female ratio 1:1.4, age range 17–75 years) who had undergone preoperative DTI-FT for FN identification. The mean tumor size among the studies ranged from 29 to 41.3 mm. Preoperative DTI-FT could not visualize the FN tract in 8 patients (3.4%) and its findings could not be verified in 3 patients (1.2%), were verified but discordant in 18 patients (7.6%), and were verified and concordant in 205 patients (87.1%).CONCLUSIONSPreoperative DTI-FT for FN identification is a useful adjunct in the surgical planning for large VSs (> 2.5 cm). A pooled analysis showed that DTI-FT successfully identifies the complete FN course in 96.6% of VSs (226 of 234 cases) and that FN identification by DTI-FT is accurate in 90.6% of cases (205 of 226 cases). Larger studies with DTI-FT–integrated neuronavigation are required to look at the direct benefit offered by this specific technique in preserving postoperative FN function.

Preoperative identification of the facial nerve in patients with large cerebellopontine angle tumors using high-density diffusion tensor imaging

2012 ◽  
Vol 116 (4) ◽  
pp. 697-702 ◽  
Author(s):  
Neil Roundy ◽  
Johnny B. Delashaw ◽  
Justin S. Cetas
Keyword(s):  
Diffusion Tensor Imaging ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
High Density ◽  
Imaging Method ◽  
Study Objective ◽  
Nerve Preservation ◽  
Imaging Results

Object Facial nerve paresis can be a devastating complication following resection of large (> 2.5 cm) cerebellopontine angle (CPA) tumors. The authors have developed and used a new high-density diffusion tensor imaging (HD-DT imaging) method, aimed at preoperatively identifying the location and course of the facial nerve in relation to large CPA tumors. Their study objective was to preoperatively identify the facial nerve in patients with large CPA tumors and compare their HD-DT imaging method with a traditional standard DT imaging method and correlate with intraoperative findings. Methods The authors prospectively studied 5 patients with large (> 2.5 cm) CPA tumors. All patients underwent preoperative traditional standard- and HD-DT imaging. Imaging results were correlated with intraoperative findings. Results Utilizing their HD-DT imaging method, the authors positively identified the location and course of the facial nerve in all patients. In contrast, using a standard DT imaging method, the authors were unable to identify the facial nerve in 4 of the 5 patients. Conclusions The HD-DT imaging method that the authors describe and use has proven to be a powerful, accurate, and rapid method for preoperatively identifying the facial nerve in relation to large CPA tumors. Routine integration of HD-DT imaging in preoperative planning for CPA tumor resection could lead to improved facial nerve preservation.

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