Preoperative diffusion tensor imaging for facial nerve identification and treatment outcome in Vestibular Schwannoma

Abstract

Preservation of the facial nerve (FN) and vestibulocochlear nerve is essential to keep the quality of life of patients during surgery for the treatment of vestibular schwannoma (VS). One of the great challenges for neurosurgeons is to make a good surgical planning, to identify a tumor location, as well as its relationship with anatomical and nervous structures to facilitate the surgeon’s work and avoid inappropriate conducts. Currently, many studies have reported the effectiveness of the diffusion tensor and tractography imaging (DTI) technique. We conducted a systematic review of studies that report the use of this technique.The PubMed and Embase databases were used to search, according to pre-established inclusion and exclusion criteria. Twelve articles were selected for this study, with a total of 255 patients who underwent a DTI preoperatively. The location and path of the facial nerve were verified intraoperatively, and 226 (89%) correlated the DTI result with the intraoperative finding, which met our inclusion criteria. The results of this research pointed to the excellent result of the DTI to predict the location of the FN in the preoperative period, allowing greater surgical planning and improvement in the outcome of the facial nerve function.