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Yao L, Wang B, Lu F, He X, Lu G, Zhang S. Facial nerve in skullbase tumors: imaging and clinical relevance. Eur J Med Res 2023; 28:121. [PMID: 36918971 PMCID: PMC10012458 DOI: 10.1186/s40001-023-01078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
Facial nerve, the 7th cranial nerve, is a mixed nerve composed of sensory and motor fibers, and its main branch is situated in the cerebellopontine angle. Facial nerve dysfunction is a debilitating phenomenon that can occur in skullbase tumors and Bell's pals. Recovery of the facial nerve dysfunction after surgery for skullbase tumors can be disappointing, but is usually favorable in Bell's palsy. Advances in magnetic resonance imaging (MRI) allow to visualize the facial nerve and its course in the cerebellopontine angle, also when a large tumor is present and compresses the nerve. Here, we describe the anatomical, neurochemical and clinical aspects of the facial nerve and highlight the recent progress in visualizing the facial nerve with MRI.
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Affiliation(s)
- Longping Yao
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.,Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Baoyan Wang
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Fengfei Lu
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Xiaozheng He
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Guohui Lu
- Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Shizhong Zhang
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
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The Application of Contrast-Enhanced 3D-STIR-VISTA MR Imaging of the Brachial Plexus. J Belg Soc Radiol 2022; 106:75. [PMID: 36134175 PMCID: PMC9461682 DOI: 10.5334/jbsr.2803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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Herrmann DP, Müller-Graff FT, Kaulitz S, Cebulla M, Kurz A, Hagen R, Neun T, Rak K. Application of intentional facial nerve stimulation during cochlear implantation as an electrophysiological tool to estimate the intracochlear electrode position. Sci Rep 2022; 12:13426. [PMID: 35927465 PMCID: PMC9352782 DOI: 10.1038/s41598-022-17732-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
This proof of concept describes the use of evoked electromyographic (EMG) activation of the facial nerve for intraoperative monitoring of the electrode insertion during cochlear implantation (CI). Intraoperative EMG measurements from the facial nerve were conducted in nine patients undergoing CI implantation. Electric current pulses were emitted from contacts on the CI array during and immediately after electrode insertion. For control, the results of EMG measurements were compared to postoperative flat panel volume computed tomography scans with secondary reconstruction (fpVCTSECO). During insertion, the EMG response evoked by the electrical stimulation from the CI was growing with the stimulating contact approaching the facial nerve and declined with increasing distance. After full insertion, contacts on the apical half of the CI array stimulated higher EMG responses compared with those on the basal half. Comparison with postoperative imaging demonstrated that electrode contacts stimulating high EMG responses had the shortest distances to the facial nerve. It could be demonstrated that electrically evoked EMG activation of the facial nerve can be used to monitor the progress during CI electrode insertion and to control the intracochlear electrode position after full insertion.
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Affiliation(s)
- David P Herrmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Stefan Kaulitz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Mario Cebulla
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Tilmann Neun
- Department of Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany.
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Fan Y, Banalagay RA, Cass ND, Noble JH, Tawfik KO, Labadie RF, Dawant BM. Automatic Segmentation of Intracochlear Anatomy in MR Images Using a Weighted Active Shape Model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3573-3576. [PMID: 34892011 PMCID: PMC8964074 DOI: 10.1109/embc46164.2021.9630332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is evidence that cochlear MR signal intensity may be useful in prognosticating the risk of hearing loss after middle cranial fossa (MCF) resection of acoustic neuroma (AN), but the manual segmentation of this structure is difficult and prone to error. This hampers both large-scale retrospective studies and routine clinical use of this information. To address this issue, we present a fully automatic method that permits the segmentation of the intra-cochlear anatomy in MR images, which uses a weighted active shape model we have developed and validated to segment the intra-cochlear anatomy in CT images. We take advantage of a dataset for which both CT and MR images are available to validate our method on 132 ears in 66 high-resolution T2-weighted MR images. Using the CT segmentation as ground truth, we achieve a mean Dice (DSC) value of 0.81 and 0.79 for the scala tympani (ST) and the scala vestibuli (SV), which are the two main intracochlear structures.Clinical Relevance- The proposed method is accurate and fully automated for MR image segmentation. It can be used to support large retrospective studies that explore relations between MR signal in preoperative images and outcomes. It can also facilitate the routine and clinical use of this information.
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Taeger J, Müller-Graff FT, Ilgen L, Schendzielorz P, Hagen R, Neun T, Rak K. Cochlear Duct Length Measurements in Computed Tomography and Magnetic Resonance Imaging Using Newly Developed Techniques. OTO Open 2021; 5:2473974X211045312. [PMID: 34595367 PMCID: PMC8477698 DOI: 10.1177/2473974x211045312] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT). Study Design Retrospective data analyses of 42 cochleae. Setting Tertiary care medical center. Methods Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2-turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2-turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method. Results CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P < .001) but not by ECA. Similar 2-turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P < .001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P < .001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28-mm CDL). Conclusion In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation-free cochlear implantation could be established.
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Affiliation(s)
- Johannes Taeger
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Franz Tassilo Müller-Graff
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Lukas Ilgen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Phillip Schendzielorz
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Tilman Neun
- Department of Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
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Lee SA, Jo SW, Chang SK, Kwon KH. Improvement of the Diagnostic Performance of Facial Neuritis Using Contrast-Enhanced 3D T1 Black-Blood Imaging: Comparison with Contrast-Enhanced 3D T1-Spoiled Gradient-Echo Imaging. J Clin Med 2021; 10:jcm10091850. [PMID: 33923134 PMCID: PMC8141108 DOI: 10.3390/jcm10091850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
This study aims to investigate the diagnostic ability of the contrast-enhanced 3D T1 black-blood fast spin-echo (T1 BB-FSE) sequence compared with the contrast-enhanced 3D T1-spoiled gradient-echo (CE-GRE) sequence in patients with facial neuritis. Forty-five patients with facial neuritis who underwent temporal bone MR imaging, including T1 BB-FSE and CE-GRE imaging, were examined. Two reviewers independently assessed the T1 BB-FSE and CE-GRE images in terms of diagnostic performance, and qualitative (diagnostic confidence and visual asymmetric enhancement) and quantitative analysis (contrast-enhancing lesion extent of the canalicular segment of the affected facial nerve (LEC) and the affected side-to-normal signal intensity ratio (rSI)). The AUCs of each reviewer, and the sensitivity and accuracy of T1 BB-FSE were significantly superior to those of CE-GRE (p < 0.05). Regarding diagnostic confidence and visual asymmetric enhancement, T1 BB-FSE tended to be rated greater than CE-GRE (p < 0.05). Additionally, in quantitative analysis, LEC and rSI of the canalicular segment on T1 BB-FSE were larger than those on CE-GRE (p < 0.05). The T1 BB-FSE sequence was significantly superior to the CE-GRE sequence, with more conspicuous lesion visualization in terms of both qualitative and quantitative aspects in patients with facial neuritis.
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Affiliation(s)
- Seun-Ah Lee
- Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, 7, Keunjaebong-gil, Hwaseong-si 18450, Gyeonggi-do, Korea; (S.-A.L.); (S.-K.C.)
| | - Sang-Won Jo
- Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, 7, Keunjaebong-gil, Hwaseong-si 18450, Gyeonggi-do, Korea; (S.-A.L.); (S.-K.C.)
- Correspondence: ; Tel.: +82-032-8086-2588
| | - Suk-Ki Chang
- Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, 7, Keunjaebong-gil, Hwaseong-si 18450, Gyeonggi-do, Korea; (S.-A.L.); (S.-K.C.)
| | - Ki-Han Kwon
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, 7, Keunjaebong-gil, Hwaseong-si 18450, Gyeonggi-do, Korea;
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Azuma M, Kadota Y, Matsuyama M, Moritake H, Hirai T. 3D fat-suppressed T1-weighted volume isotropic turbo spin-echo acquisition (VISTA) imaging for the evaluation of the ectopic posterior pituitary gland. Jpn J Radiol 2021; 39:564-570. [PMID: 33864182 DOI: 10.1007/s11604-020-01076-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/22/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We evaluated the usefulness of fat-suppressed three-dimensional T1-weighted volume isotropic turbo spin-echo acquisition (FS 3D T1W-VISTA) imaging for the evaluation of the ectopic posterior pituitary gland (EPPG). MATERIALS AND METHODS This retrospective study included 9 patients with EPPG due to causes other than tumor. All underwent sagittal two-dimensional (2D) T1W-, FS 3D T1W-VISTA- (VISTA), and 3D T2W-driven equilibrium radiofrequency reset pulse (DRIVE) imaging. Two radiologists independently reviewed the 2D T1W- and VISTA images for their image quality and for visualization of the EPPG and of pituitary stalk transection. DRIVE findings were used as the reference standard for pituitary stalk transection. Interobserver and intermodality agreements were evaluated with the kappa (κ) coefficient. The mean grade assigned to the 2D T1W- and the VISTA imaging technique for visualization of the EPPG was assessed by the Mann-Whitney U test. RESULTS Interobserver agreement for visualization of the EPPG on 2D T1W- and VISTA images was excellent (κ = 0.82 and κ = 1.00, respectively). The mean grade for EPPG visualization was significantly higher for VISTA- than 2D T1W images (p = 0.0039). CONCLUSION FS 3D T1W-VISTA imaging is useful for the evaluation of EPPG. Conventional MRI yields insufficient information for the evaluation of the ectopic posterior pituitary gland (EPPG). The visualization of the EPPG was significantly higher for fat-suppressed three-dimensional T1-weighted volume isotropic turbo spin-echo acquisition (FS 3D T1W-VISTA) than 2D T1W images. FS 3D T1W-VISTA imaging is useful for the evaluation of the EPPG.
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Affiliation(s)
- Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
| | - Yoshihito Kadota
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Misayo Matsuyama
- Department of Pediatrics, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Moritake
- Department of Pediatrics, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Ehrmann-Müller D, Shehata-Dieler W, Kaulitz S, Back D, Kurz A, Kühn H, Hagen R, Rak K. Cochlear implantation in children without preoperative computed tomography diagnostics. Analysis of procedure and rate of complications. Int J Pediatr Otorhinolaryngol 2020; 138:110266. [PMID: 32866797 DOI: 10.1016/j.ijporl.2020.110266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION To evaluate the safety in cochlear implantation without preoperative computed tomography diagnostics, which was implemented into the protocol of cochlear implantation in 2013, since in the year before, new evidence concerning the risks of ionizing radiation especially in children arose. METHODS In this retrospective data analysis 89 children under 36 months, which were cochlear implanted from 2008 until 2018 at a tertiary referral centre with a large cochlear implant program were analysed. Fortyfour of the children were implanted before the date of change in 2013 and 45 in the following years up to now. The data about the operative procedures, the postoperative care and the complication rate before and after implementation of the new protocol were compared. RESULTS Before the date of change in 2013, 100% of patients received preoperative CT diagnostics, in the following years 13.3%. No difference in the duration of surgery, the procedure related and the late complications between the two groups was identified. CONCLUSION Cochlear implantation in very young children under the age of 36 months without preoperative radiological diagnostics by CT scan of the temporal bone is a safe procedure without additional risks for the patients.
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Affiliation(s)
- Desiree Ehrmann-Müller
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Stefan Kaulitz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Daniela Back
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Heike Kühn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Germany.
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