- #MRI OF INTERNAL AUDITORY CANAL IMAGES WHICH CRANIAL HOW TO#
- #MRI OF INTERNAL AUDITORY CANAL IMAGES WHICH CRANIAL SOFTWARE#
Patients underwent routine follow-up every 3 months for 1 year and then yearly thereafter. The study was approved by the Medical Ethics Committee of Zhongnan Hospital of Wuhan University (2021037 K). Clinical data regarding patient age, sex, clinical presentation, neurological examination, neuroimaging, surgical findings, tumor size, and treatment outcomes were recorded and analyzed. Patients whose surgery was performed with the assistance of a microscope only were defined as the microsurgical group (MS group), whereas those whose surgeries were assisted by navigation and endoscopy were defined as the combined surgical group (CS group). Patients with recurrent tumors, a history of radiation therapy, high jugular bulbar, and neurofibromatosis type 2 were excluded. The cohort of this retrospective study comprised consecutive patients who had undergone RS resection of VS in our institution from April 2018 to December 2021.
#MRI OF INTERNAL AUDITORY CANAL IMAGES WHICH CRANIAL HOW TO#
The aim of this study was to investigate how to precisely expose the intrameatal portion of VSs without damaging the labyrinth.
#MRI OF INTERNAL AUDITORY CANAL IMAGES WHICH CRANIAL SOFTWARE#
Together, they are complementary, and their data can be easily and accurately integrated with the navigation system software ( 23, 24). Magnetic resonance imaging (MRI) and computed tomography (CT) fusion images are used for intraoperative navigation, as either modality alone provides inadequate clinical information. In the past few years, we have performed image-guided microsurgery with endoscopic assistance for patients with vestibular schwannoma. Furthermore, numerous reports have indicated that few tumors have a remnant at the fundus of the IAC that cannot be seen with the operative microscope ( 15, 18– 22). However, endoscopic tumor resection is a skill set that is not necessarily learned quickly, nor are microscopic skills easily transferable to the technique ( 17). Use of an endoscope may solve this problem ( 13– 16). In some cases, microscopic exposure of the tumor is incomplete, even with excessive traction of the cerebellum or extensive drilling of the posterior wall of IAC ( 12). Removal of the posterior canal wall is essential to expose the portion of the tumor residing in the IAC ( 2, 3, 6– 11). Although this approach provides excellent visualization, access to the fundus of the internal auditory canal (IAC) is limited ( 1– 5). Vestibular schwannoma (VS) resection via the retrosigmoid approach (RS) remains challenging.
Tumors of the medial type require endoscopic assistance for resection. Preoperative MRI/CT fusion imaging is helpful in preoperative evaluation and surgical planning in patients undergoing VS surgery. Endoscopic-assisted resection of residual tumor in the IAC was performed significantly more often on medial than on lateral tumors.Ĭonclusion: Navigation and endoscopy are useful in assisting the exposure of the intrameatal portion of VSs. The CS group included 29 lateral type and 24 medial type schwannomas. The labyrinth was damaged in four patients in the MS group but was not damaged in any of the CS group patients. Residual tumor was detected by postoperative MRI at the fundus of the internal auditory canal in 5 of the 31 patients in the MS group and 1 of the 53 in the CS group. Results: Data of 84 patients were analyzed. The tumors in the CS group were then divided into medial and lateral types by fusion imaging and the differences between the two types analyzed. The patients were divided into microsurgery (MS) and navigation endoscopic-assisted (combined surgery, CS) groups and the effects of image guidance and endoscopy evaluated. Methods: This was a retrospective study of patients who had undergone retrosigmoid resection of a VS in our institution from April 2018 to December 2021. Objective: The aim of this study was to investigate how to precisely expose the intrameatal portion of vestibular schwannomas (VSs) without damaging the labyrinth. 2Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, China.1Department of neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China.
Chenguang Jia 1,2†, Chengshi Xu 1,2†, Mengyang Wang 1,2† and Jincao Chen 1,2*
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