The use of cochlear-enhancement imaging to predict hearing preservation following vestibular schwannoma removal.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY Journal of neurosurgical sciences Pub Date : 2024-04-01 Epub Date: 2021-05-03 DOI:10.23736/S0390-5616.21.05395-9

Woo-Hyun Kim, Hun H Park, Sung J Ahn, Mina Park, Chang K Hong

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Abstract

Background: Hearing preservation is challenging for patients after the removal of large vestibular schwannomas (VSs). Here, using preoperative magnetic resonance (MR) imaging, we investigated the significance of cochlear enhancement (CE) for predicting postoperative hearing preservation.

Methods: Between January 2014 and December 2019, 34 VS-patients with serviceable hearing underwent tumor-removal surgery using a retrosigmoid approach. The presence or absence of CE using both T2-weighted and gadolinium-enhanced T1-weighted MR images was assessed in VS patients using the pixel-analysis method. Segmented volumetric analyses were also performed using GrowCut 3D slicer software.

Results: There were 17 patients (50%) without CE and 17 (50%) with CE. Ten of the 17 non-CE patients (58.8%) had postoperative hearing preservation. In contrast, only 3 of the 17 patients with CE (17.6%) had postoperative hearing preservation. There were no significant tumor-characteristic differences between the two groups. The presence of CE on both the T2-weighted and the gadolinium-enhanced T1-weighted MR images correlated significantly with postoperative hearing outcomes (P=0.032). Only pure-tone averages were significantly different between the two groups (P=0.049).

Conclusions: Preoperative serviceable hearing is likely to be preserved after surgery in non-CE VS patients. Preoperative CE assessment using MR imaging may be a useful predictor for postoperative hearing outcomes in VS patients.

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利用耳蜗增强成像预测前庭裂孔瘤切除术后的听力保存情况。

背景：对于切除大型前庭裂瘤（VSs）的患者来说，听力保护是一项挑战。在此，我们利用术前磁共振（MR）成像，研究了耳蜗增强（CE）对预测术后听力保存的意义：方法：2014 年 1 月至 2019 年 12 月期间，34 名听力尚可的 VS 患者接受了肿瘤切除手术，手术采用的是回盲法。采用像素分析方法，利用T2加权和钆增强T1加权磁共振图像评估VS患者是否存在CE。此外，还使用 GrowCut 3D 切片软件进行了分割容积分析：17名患者（50%）无 CE，17 名患者（50%）有 CE。在 17 位非 CE 患者中，有 10 位（58.8%）术后保留了听力。相比之下，17 位 CE 患者中只有 3 位（17.6%）术后听力得以保留。两组患者的肿瘤特征无明显差异。T2加权和钆增强T1加权磁共振图像上出现CE与术后听力结果有显著相关性（p = 0.032）。只有纯音平均值在两组之间存在显著差异（p = 0.049）：结论：非 CE VS 患者术前的可用听力很可能在术后得到保留。使用磁共振成像进行术前 CE 评估可能是 VS 患者术后听力结果的有效预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY

CiteScore

3.00

自引率

5.30%

发文量

202

审稿时长

>12 weeks

期刊介绍： The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.