caa a22 4500 606214259 CHVBK 20210128101051.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00701-015-2431-7 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2431-7 Identification of cranial nerves near large vestibular schwannomas using superselective diffusion tensor tractography: experience with 23 cases [Elektronische Daten] [Peng-Hu Wei, Zhi-Gang Qi, Ge Chen, Peng Hu, Ming-Chu Li, Jian-Tao Liang, Hong-Chuan Guo, Feng Ling, Yu-Hai Bao] Background: The preservation of the facial nerve (FN) and acoustic function in large vestibular schwannoma (VS) surgery is challenging because of nerve course uncertainties and morphological deviations. Preoperative diffusion tensor tractography (DTT) has been proposed to predict the FN location. This study was conducted to evaluate the effectiveness of this technique for identifying the FN, cochlear nerve (CN) and trigeminal nerve (TN) in large VSs. Methods: The study included 23 consecutive patients with VS of Hannover classification T3b to T4b from November 2013 through May 2014. Diffusion tensor images and anatomical images were acquired. The DTT images of the cranial nerves were extracted before surgery for each patient to determine the relationships of these nerves with the tumor. The results were then validated during the tumorectomy. Results: In 21 (91.30%) patients, the location of the FN on the DTT images agreed with the intraoperative findings, including in 2 patients in whom the FN passed through the interface between the parenchyma and the cystic changes and in 3 patients with a membranoid FN. The CN or fibers of unclear function were observed on DTT images in four patients with functional hearing. One penetrating fiber of unknown function was effectively constructed. The TN was accurately detected on the DTT images for all patients. Conclusions: DTT effectively revealed the location of the FN, including cases in which the FN was membranoid or passed through the interface between an area exhibiting cystic changes and the tumor nodule. Fibers aside from the FN and the TN were revealed by DTT in patients who retained functional hearing. Penetrating fibers were also found using DTT. This technique can be useful during VS resection. Springer-Verlag Wien, 2015 Vestibular schwannoma nationallicence Diffusion tensor tractography nationallicence Facial nerve nationallicence Cochlear nerve nationallicence Wei Peng-Hu Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Qi Zhi-Gang Department of Radiology, Xuan Wu Hospital, Capital Medical University, 100053, Beijing, China aut Chen Ge Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Hu Peng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Li Ming-Chu Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Liang Jian-Tao Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Guo Hong-Chuan Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Ling Feng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Bao Yu-Hai Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1239-1249 0001-6268 157:7<1239 2015 157 701 https://doi.org/10.1007/s00701-015-2431-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2431-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wei Peng-Hu Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Qi Zhi-Gang Department of Radiology, Xuan Wu Hospital, Capital Medical University, 100053, Beijing, China aut NATIONALLICENCE 700 1- Chen Ge Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Hu Peng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Li Ming-Chu Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Liang Jian-Tao Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Guo Hong-Chuan Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Ling Feng Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 700 1- Bao Yu-Hai Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, 100053, Beijing, China aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1239-1249 0001-6268 157:7<1239 2015 157 701