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Feasibility of diffusion tensor tractography for preoperative prediction of the location of the facial and vestibulocochlear nerves in relation to vestibular schwannoma

  • Clinical Article - Brain Tumors
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Abstract

Background

According to recent findings, diffusion tensor tractography (DTT) only allows prediction of facial nerve location in relation to vestibular schwannoma (VS) with high probability. However, previous studies have not mentioned why only the facial nerve was selectively visualized. Our previous report investigated the optimal conditions of DTT for normal facial and vestibulocochlear nerves. In the present study, we applied the optimal conditions of DTT to VS patients to assess the feasibility of DTT for the facial and vestibulocochlear nerves.

Methods

We investigated 11 patients with VS who underwent tumor resection. Visualized tracts were compared with locations of the facial and cochlear nerves as identified by intraoperative electrophysiological monitoring.

Results

With the proposed method, visualized tracts corresponded to pathway area of the facial or cochlear nerves in nine of 11 patients (81.8 %); specifically, to the pathway area of the facial nerve in three of 11 patients (27.3 %), and to the pathway area of the cochlear nerve in six of 11 patients (54.5 %).

Conclusions

We visualized facial or vestibulocochlear nerves in nine of 11 patients (81.8 %). For the first time, DTT proved able to visualize not only the facial nerve but also the vestibulocochlear nerve in VS patients. Despite our findings, good methods for distinguishing whether a visualized nerve tract represents facial nerve, vestibulocochlear nerve, or only noise remain unavailable. Close attention should therefore be paid to the interpretation of visualized fibers.

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Abbreviations

DTT:

Diffusion tensor tractography

ESE-DNAP:

Elicited dorsal cochlear nucleus action potential

FA:

Fractional anisotropy

ROI:

Region of interest

VS:

Vestibular schwannoma

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Acknowledgments

This work was supported in part by Grant-in-Aid for Challenging Exploratory Research 25670618. We wish to thank Minoru Tanaka for suggesting this investigation.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Masanori Yoshino, Taichi Kin, Akihiro Ito, Daichi Nakagawa, Hirofumi Nakatomi & Nobuhito Saito

  2. Departments of Clinical Information Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Toki Saito & Hiroshi Oyama

  3. Department of Neurosurgery, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan

    Kyousuke Kamada

  4. Departments of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kenji Ino, Harushi Mori & Akira Kunimatsu

Authors
  1. Masanori Yoshino
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  2. Taichi Kin
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  3. Akihiro Ito
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  4. Toki Saito
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  5. Daichi Nakagawa
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  6. Kenji Ino
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  7. Kyousuke Kamada
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  8. Harushi Mori
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  9. Akira Kunimatsu
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  10. Hirofumi Nakatomi
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  11. Hiroshi Oyama
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  12. Nobuhito Saito
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Corresponding author

Correspondence to Masanori Yoshino.

Additional information

Comments

The authors describe a novel modification of a DTI/DTT technique to identify the cochlear nerve by increasing the fraction anisotropy (FA) threshold. While this technique decreases the ability to identify facial nerves, it has a merit in identifying the cochlear nerve, which would be of importance if a hearing-preservation surgery is planned. The identification of vestibular nerves and potential misinterpretation between the vestibular nerve and cochlear nerve is a major concern with this method. Future modification of this technique will hopefully enable us to obtain accurate identification of both facial and cochlear nerves by adjusting the FA threshold in the same setting and identifying different cranial nerve trajectory.

Amir Dehdashti

NY, USA

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Yoshino, M., Kin, T., Ito, A. et al. Feasibility of diffusion tensor tractography for preoperative prediction of the location of the facial and vestibulocochlear nerves in relation to vestibular schwannoma. Acta Neurochir 157, 939–946 (2015). https://doi.org/10.1007/s00701-015-2411-y

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  • DOI: https://doi.org/10.1007/s00701-015-2411-y

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