Preoperative prediction of facial nerve in patients with Vestibular Schwannomas: the role of diffusion tensor imaging. A systematic review.

Preoperative prediction of facial nerve in patients with Vestibular Schwannomas: the role of diffusion tensor imaging. A systematic review.

World Neurosurg. 2019 Jan 29;:

Authors: Baro V, Landi A, Brigadoi S, Castellaro M, Moretto M, Anglani M, Ermani M, Causin F, Denaro L, Bertoldo A, d'Avella D

Abstract
In vestibular schwannoma surgery the preservation of facial and cochlear nerves is of paramount concern with regard to their impact on the quality of life. The rate of nerve function preservation raised on account of advancement in surgical technique and neuroimaging and as well as the introduction of intraoperative neuromonitoring. Preoperative depiction of anatomical concerns between nerves and tumour could help the surgical planning; indeed many studies investigating advanced imaging for cranial nerves detection, in particular diffusion tensor imaging, have been published from the last decade. A systematic review of the literature evaluating preoperative facial nerve fiber tracking followed by intraoperative verification was conducted. Seventeen articles met our inclusion criteria, identifying 223 patients (mean age 47.5 years, range 17-77 years, male:female ratio 1:1.4). Preoperative facial nerve fiber tracking was obtained in 214 patients (96%) and the subsequent intraoperative verification revealed a correct prediction in 187 cases (85.5%). This review confirms that preoperative fiber tracking for facial nerve identification, in large vestibular schwannoma surgery, is a valuable and reliable instrument, nonetheless the studies are not comparable in terms of images, acquisitions and post-processing elaboration. Larger series and homogenous MRI parameters are required to strengthen these findings.

PMID: 30708084 [PubMed - as supplied by publisher]

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