Woo-Hyun Kim, Hun H Park, Sung J Ahn, Mina Park, Chang K Hong
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引用次数: 0
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.
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。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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