Wydawnictwo Medyczne Mediton
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the Polish Society of Audiology and Phoniatrics

 

Original articles

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Diffusion tractography of facial nerve in cerebello-pontine angle tumours
Tomasz Szmuda 1/, Paweł Słoniewski 1/, Agnieszka Sabisz 2/, Marta Szmuda 3/
  • 1/ Katedra i Klinika Neurochirurgii, Centrum Medycyny Inwazyjnej, Gdański Uniwersytet Medyczny
  • 2/ Zakład Radiologii, Uniwersyteckie Centrum Kliniczne, Centrum Medycyny Inwazyjnej, Gdański Uniwersytet Medyczny
  • 3/ Katedra Neurologii, Klinika Neurologii Rozwojowej, Gdański Uniwersytet Medyczny

Introduction. Preoperative imaging of the facial nerve (FN) in relation to cerebello-pontine angle (CPA) tumour would allow the surgeon to increase the safety of tumour resection. Tractography based on diffusion tensor imaging (DTI) is a novel method for visualisation of the white matter fibres and the cranial nerves.

Aim. To evaluate the correspondence of preoperative DTI with real FN position and assess the impact of FN imaging on reduction of facial paresis rate.

Material and methods. In 2013-2014, DTI with 3D modelling of CPA tumor was performed in 7 patients in the Neurosurgery Department of the Medical University of Gdańsk. Various factors were analysed, including age, gender, tumour size, its histopathology, and FN real and DTI location.

Results. Postoperative facial paresis was diagnosed in 3 patients (42.9%). In one patient, an eigenvector error of DTI occurred. The real position of FN corresponded with DTI only in 57% of patients. The sensitivity of 80% (95%CI:28.8-96.7%) was achieved. None of examined factors was significantly related to the agreement of the DTI with the real FN position. The correct prediction of FN location by means of DTI did not influence the reduction of postoperative facial paresis.

Conclusions. Contrary to some previous reports, sensitivity of DTI in CPA tumours has been found to be low in our study. Further prospective studies involving a greater number of subjects are required to establish a firm position of DTI in FN visualisation.

Otorynolaryngologia vol 13. no 1. Marchpages: from 42to 50
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