Effectiveness of preoperative facial nerve diffusion tensor imaging tractography for preservation of facial nerve function in surgery for large vestibular schwannomas: Results of a prospective randomized study
Background: The goal of surgery in case of a large vestibular schwannoma is complete excision of tumor and preservation of facial nerve function. The identification and preservation of facial nerve is very difficult during surgery, particularly in case of large tumors. This prospective randomized st...
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| Veröffentlicht in: | Neurology India 2019-01, Vol.67 (1), p.149-154 |
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| creator | Samala, Raghu Borkar, Sachin Sharma, Ravi Garg, Ajay Suri, Ashish Gupta, Deepak Kale, Shashank |
| description | Background: The goal of surgery in case of a large vestibular schwannoma is complete excision of tumor and preservation of facial nerve function. The identification and preservation of facial nerve is very difficult during surgery, particularly in case of large tumors. This prospective randomized study was conducted to find out the effectiveness of preoperative facial nerve diffusion tensor imaging tractography (DTI) to predict location of the nerve and preservation of facial nerve function in surgery for large vestibular schwannomas.
Materials and Methods: In this prospective randomized study, we recruited 100 patients with a large vestibular schwannoma(> 3cm). After initial scrutiny, 94 patients were randomized based on a computer generated chart. In group I, preoperative DTI was done and the operating surgeon was informed about the position of facial nerve preoperatively. In group II, DTI was not done. The facial nerve preservation rates and clinical outcome at follow up was compared between the two groups.
Results: Out of 94 patients, there were 47 patients in group I (DTI group) and 47 patients in group II (Non DTI group). In DTI group, 40 patients were left for comparison after the exclusion criteria was applied. Preoperative DTI predicted that the facial nerve position was concordant with its intraoperative position in 39 patients (97.5% concordance). Facial nerve preservation rates were statistically significant in group I (DTI group) (P value = 0.002).
Conclusion: The study establishes the role of preoperative DTI tractography for better facial nerve preservation in surgery for large vestibular schwannomas (>3 cm). |
| doi_str_mv | 10.4103/0028-3886.253631 |
| format | Article |
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Materials and Methods: In this prospective randomized study, we recruited 100 patients with a large vestibular schwannoma(> 3cm). After initial scrutiny, 94 patients were randomized based on a computer generated chart. In group I, preoperative DTI was done and the operating surgeon was informed about the position of facial nerve preoperatively. In group II, DTI was not done. The facial nerve preservation rates and clinical outcome at follow up was compared between the two groups.
Results: Out of 94 patients, there were 47 patients in group I (DTI group) and 47 patients in group II (Non DTI group). In DTI group, 40 patients were left for comparison after the exclusion criteria was applied. Preoperative DTI predicted that the facial nerve position was concordant with its intraoperative position in 39 patients (97.5% concordance). Facial nerve preservation rates were statistically significant in group I (DTI group) (P value = 0.002).
Conclusion: The study establishes the role of preoperative DTI tractography for better facial nerve preservation in surgery for large vestibular schwannomas (>3 cm).</description><identifier>ISSN: 0028-3886</identifier><identifier>EISSN: 1998-4022</identifier><identifier>DOI: 10.4103/0028-3886.253631</identifier><identifier>PMID: 30860114</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Acoustic neuroma ; Adolescent ; Adult ; Aged ; Care and treatment ; Child ; Diffusion Tensor Imaging - methods ; Evaluation ; Facial Nerve - diagnostic imaging ; Facial Nerve - surgery ; Facial Nerve Injuries - etiology ; Facial Nerve Injuries - prevention & control ; Female ; Health aspects ; Humans ; Magnetic resonance imaging ; Male ; Medical imaging equipment ; Methods ; Middle Aged ; Nervous system tumors ; Neuroma, Acoustic - diagnostic imaging ; Neuroma, Acoustic - surgery ; Neurosurgery ; Neurosurgical Procedures - adverse effects ; Preoperative care ; Prospective Studies ; Software ; Studies ; Surgeons ; Surgery ; Treatment Outcome ; Tumor removal ; Tumors ; Vestibulocochlear nerve ; Young Adult</subject><ispartof>Neurology India, 2019-01, Vol.67 (1), p.149-154</ispartof><rights>COPYRIGHT 2019 Medknow Publications and Media Pvt. Ltd.</rights><rights>2019. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491v-15b9d10a676da50343c480b5b352ebaea510fd24b6db55cddb64587635f17b4b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30860114$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samala, Raghu</creatorcontrib><creatorcontrib>Borkar, Sachin</creatorcontrib><creatorcontrib>Sharma, Ravi</creatorcontrib><creatorcontrib>Garg, Ajay</creatorcontrib><creatorcontrib>Suri, Ashish</creatorcontrib><creatorcontrib>Gupta, Deepak</creatorcontrib><creatorcontrib>Kale, Shashank</creatorcontrib><title>Effectiveness of preoperative facial nerve diffusion tensor imaging tractography for preservation of facial nerve function in surgery for large vestibular schwannomas: Results of a prospective randomized study</title><title>Neurology India</title><addtitle>Neurol India</addtitle><description>Background: The goal of surgery in case of a large vestibular schwannoma is complete excision of tumor and preservation of facial nerve function. The identification and preservation of facial nerve is very difficult during surgery, particularly in case of large tumors. This prospective randomized study was conducted to find out the effectiveness of preoperative facial nerve diffusion tensor imaging tractography (DTI) to predict location of the nerve and preservation of facial nerve function in surgery for large vestibular schwannomas.
Materials and Methods: In this prospective randomized study, we recruited 100 patients with a large vestibular schwannoma(> 3cm). After initial scrutiny, 94 patients were randomized based on a computer generated chart. In group I, preoperative DTI was done and the operating surgeon was informed about the position of facial nerve preoperatively. In group II, DTI was not done. The facial nerve preservation rates and clinical outcome at follow up was compared between the two groups.
Results: Out of 94 patients, there were 47 patients in group I (DTI group) and 47 patients in group II (Non DTI group). In DTI group, 40 patients were left for comparison after the exclusion criteria was applied. Preoperative DTI predicted that the facial nerve position was concordant with its intraoperative position in 39 patients (97.5% concordance). Facial nerve preservation rates were statistically significant in group I (DTI group) (P value = 0.002).
Conclusion: The study establishes the role of preoperative DTI tractography for better facial nerve preservation in surgery for large vestibular schwannomas (>3 cm).</description><subject>Acoustic neuroma</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Diffusion Tensor Imaging - methods</subject><subject>Evaluation</subject><subject>Facial Nerve - diagnostic imaging</subject><subject>Facial Nerve - surgery</subject><subject>Facial Nerve Injuries - etiology</subject><subject>Facial Nerve Injuries - prevention & control</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical imaging equipment</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Nervous system tumors</subject><subject>Neuroma, Acoustic - diagnostic imaging</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Preoperative care</subject><subject>Prospective Studies</subject><subject>Software</subject><subject>Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor removal</subject><subject>Tumors</subject><subject>Vestibulocochlear nerve</subject><subject>Young Adult</subject><issn>0028-3886</issn><issn>1998-4022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkk9v1DAQxSMEokvhzglZ4sIlix3b2YRbW5U_UiUkBGfLicep26y92Mmulm_JN2LStIVFKx_i8fze08R-Wfaa0aVglL-ntKhyXlXlspC85OxJtmB1XeWCFsXTbPHYPslepHSDJeeseJ6dcFqVlDGxyH5fWgvt4LbgISUSLNlECBuIejojVrdO98RDxMI4a8fkgicD-BQicWvdOd-RIep2CF3Um-s9sdhAj4QS9EAYPQ9s7Ojbu4bzJI2xgziLeo17soU0uGbEgqT2eqe9D2udPpBvkMZ-uJtQo39Im3lsErU3Ye1-gSFpGM3-ZfbM6j7Bq_vvafbj4-X3i8_51ddPXy7OrvJW1GybM9nUhlFdrkqjJeWCt6KijWy4LKDRoCWj1hSiKU0jZWtMUwpZrUouLVs1ouGn2bvZF4f5OeLUau1SC32vPYQxqYLVVFSlqAtE3_6H3oQxepxuoliByEr-pTrdg3LehuleJ1N1JlcVrwspOFL5EarD54u6Dx6sw-MDfnmEx2Vg7dqjAjoLWrzkFMGqTcSHjnvFqJpSp6ZYqSlWak4dSt7c_9_YrME8Ch5ihsD5DOxCP0BMt_24g6iQvfVhd2Cc_2OsmKjVQ0D5H16T65Y</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Samala, Raghu</creator><creator>Borkar, Sachin</creator><creator>Sharma, Ravi</creator><creator>Garg, Ajay</creator><creator>Suri, Ashish</creator><creator>Gupta, Deepak</creator><creator>Kale, Shashank</creator><general>Wolters Kluwer India Pvt. 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The identification and preservation of facial nerve is very difficult during surgery, particularly in case of large tumors. This prospective randomized study was conducted to find out the effectiveness of preoperative facial nerve diffusion tensor imaging tractography (DTI) to predict location of the nerve and preservation of facial nerve function in surgery for large vestibular schwannomas.
Materials and Methods: In this prospective randomized study, we recruited 100 patients with a large vestibular schwannoma(> 3cm). After initial scrutiny, 94 patients were randomized based on a computer generated chart. In group I, preoperative DTI was done and the operating surgeon was informed about the position of facial nerve preoperatively. In group II, DTI was not done. The facial nerve preservation rates and clinical outcome at follow up was compared between the two groups.
Results: Out of 94 patients, there were 47 patients in group I (DTI group) and 47 patients in group II (Non DTI group). In DTI group, 40 patients were left for comparison after the exclusion criteria was applied. Preoperative DTI predicted that the facial nerve position was concordant with its intraoperative position in 39 patients (97.5% concordance). Facial nerve preservation rates were statistically significant in group I (DTI group) (P value = 0.002).
Conclusion: The study establishes the role of preoperative DTI tractography for better facial nerve preservation in surgery for large vestibular schwannomas (>3 cm).</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>30860114</pmid><doi>10.4103/0028-3886.253631</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Free E-Journal (出版社公開部分のみ） |
| subjects | Acoustic neuroma Adolescent Adult Aged Care and treatment Child Diffusion Tensor Imaging - methods Evaluation Facial Nerve - diagnostic imaging Facial Nerve - surgery Facial Nerve Injuries - etiology Facial Nerve Injuries - prevention & control Female Health aspects Humans Magnetic resonance imaging Male Medical imaging equipment Methods Middle Aged Nervous system tumors Neuroma, Acoustic - diagnostic imaging Neuroma, Acoustic - surgery Neurosurgery Neurosurgical Procedures - adverse effects Preoperative care Prospective Studies Software Studies Surgeons Surgery Treatment Outcome Tumor removal Tumors Vestibulocochlear nerve Young Adult |
| title | Effectiveness of preoperative facial nerve diffusion tensor imaging tractography for preservation of facial nerve function in surgery for large vestibular schwannomas: Results of a prospective randomized study |
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