Abstract
The current strategy in vestibular schwannoma surgery dictates early intraoperative identification of the facial nerve by means of intraoperative monitoring. Imaging studies designed to trace the course of the facial nerve preoperatively should theoretically enhance surgical safety. The use of diffusion tensor tractography (DTT) for nerve tracking has evolved as a reliable technique in this regard. The latest systematic review available in the literature showed that complete tracking of the nerve’s course was obtained in 96.6% of cases and that surgical concordance with the preoperative DTT findings was obtained in 90.7%. The authors deemed preoperative DTT for facial nerve identification a useful adjunct in the surgical planning for large tumors (>2.5 cm). The application of tractography to detailed morphological reconstruction of the cranial nerves is a recent technology; therefore, it has potential limitations. These include a limited ability to distinguish the fibers of VII and VIII nerves, which could be overcome by combining DTT with specific MRI sequences.
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References
Gerganov VM, Giordano M, Samii M, Samii A. Diffusion tensor imaging-based fiber tracking for prediction of the position of the facial nerve in relation to large vestibular schwannomas. J Neurosurg. 2011;115(6):1087–93.
Taoka T, Hirabayashi H, Nakagawa H, Sakamoto M, Myochin K, Hirohashi S, et al. Displacement of the facial nerve course by vestibular schwannoma: preoperative visualization using diffusion tensor tractography. J Magn Reson Imaging. 2006;24(5):1005–10.
Sartoretti-Schefer S, Kollias S, Valavanis A. Spatial relationship between vestibular schwannoma and facial nerve on three-dimensional T2-weighted fast spin-echo MR images. AJNR Am J Neuroradiol. 2000;21(5):810–6.
Chen DQ, Quan J, Guha A, Tymianski M, Mikulis D, Hodaie M. Three-dimensional in vivo modeling of vestibular schwannomas and surrounding cranial nerves with diffusion imaging tractography. Neurosurgery. 2011;68(4):1077–83.
Savardekar AR, Patra DP, Thakur JD, Narayan V, Mohammed N, Bollam P, et al. 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. Neurosurg Focus. 2018;44(3):E5.
Choi KS, Kim MS, Kwon HG, Jang SH, Kim OL. Preoperative identification of facial nerve in vestibular schwannomas surgery using diffusion tensor tractography. J Korean Neurosurg Soc. 2014;56(1):11–5.
Hodaie M, Quan J, Chen DQ. In vivo visualization of cranial nerve pathways in humans using diffusion-based tractography. Neurosurgery. 2010;66(4):788–95; discussion 95–6.
Zhang Y, Mao Z, Wei P, Jin Y, Ma L, Zhang J, et al. Preoperative prediction of location and shape of facial nerve in patients with large vestibular schwannomas using diffusion tensor imaging-based fiber tracking. World Neurosurg. 2017;99:70–8.
Wei PH, Qi ZG, Chen G, Hu P, Li MC, Liang JT, et al. Identification of cranial nerves near large vestibular schwannomas using superselective diffusion tensor tractography: experience with 23 cases. Acta Neurochir (Wien). 2015;157(7):1239–49.
Song F, Hou Y, Sun G, Chen X, Xu B, Huang JH, et al. In vivo visualization of the facial nerve in patients with acoustic neuroma using diffusion tensor imaging-based fiber tracking. J Neurosurg. 2016;125(4):787–94.
Hilly O, Chen JM, Birch J, Hwang E, Lin VY, Aviv RI, et al. Diffusion tensor imaging tractography of the facial nerve in patients with cerebellopontine angle tumors. Otol Neurotol. 2016;37(4):388–93. https://www.ncbi.nlm.nih.gov/pubmed/26905823.
Ung N, Mathur M, Chung LK, Cremer N, Pelargos P, Frew A, et al. A systematic analysis of the reliability of diffusion tensor imaging tractography for facial nerve imaging in patients with vestibular schwannoma. J Neurol Surg B Skull Base. 2016;77(4):314–8.
Dunn IF, Bi WL, Mukundan S, Delman BN, Parish J, Atkins T, et al. Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of imaging in the diagnosis and management of patients with vestibular schwannomas. Neurosurgery. 2018;82(2):E32–E4.
Roundy N, Delashaw JB, Cetas JS. Preoperative identification of the facial nerve in patients with large cerebellopontine angle tumors using high-density diffusion tensor imaging. J Neurosurg. 2012;116(4):697–702.
Yoshino M, Abhinav K, Yeh FC, Panesar S, Fernandes D, Pathak S, et al. Visualization of cranial nerves using high-definition fiber tractography. Neurosurgery. 2016;79(1):146–65.
Li H, Wang L, Hao S, Li D, Wu Z, Zhang L, et al. Identification of the facial nerve in relation to vestibular schwannoma using preoperative diffusion tensor tractography and intraoperative tractography-integrated neuronavigation system. World Neurosurg. 2017;107:669–77.
Yoshino M, Kin T, Ito A, Saito T, Nakagawa D, Ino K, et al. Combined use of diffusion tensor tractography and multifused contrast-enhanced FIESTA for predicting facial and cochlear nerve positions in relation to vestibular schwannoma. J Neurosurg. 2015;123(6):1480–8.
Zolal A, Juratli TA, Podlesek D, Rieger B, Kitzler HH, Linn J, et al. Probabilistic tractography of the cranial nerves in vestibular schwannoma. World Neurosurg. 2017;107:47–53.
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Campione, A., Cacciotti, G., Roperto, R., Giacobbo Scavo, C., Mastronardi, L. (2019). DTI for Facial Nerve Preoperative Prediction of Position and Course. In: Mastronardi, L., Fukushima, T., Campione, A. (eds) Advances in Vestibular Schwannoma Microneurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-03167-1_18
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DOI: https://doi.org/10.1007/978-3-030-03167-1_18
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