Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function ...Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function in patients with acoustic neuroma.Methods A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included.Clinical data and raw features from four MRI sequences(T1-weighted,T2-weighted,T1-weighted contrast enhancement,and T2-weighted-Flair images)were analyzed.Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features.Nomogram,machine learning,and convolutional neural network(CNN)models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate model performance.A total of 1050 radiomic parameters were extracted,from which 13 radiomic and 3 clinical features were selected.Results The CNN model performed best among all prediction models in the test set with an area under the curve(AUC)of 0.89(95%CI,0.84–0.91).Conclusion CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma.As such,CNN modeling may serve as a potential decision-making tool for neurosurgery.展开更多
Objective To report the authors' experiences in hearing preservation during acoustic neuroma (AN) resection procedures. Methods Two cases of AN removal via retrosigmoid approach were reviewed. Hearing preservation...Objective To report the authors' experiences in hearing preservation during acoustic neuroma (AN) resection procedures. Methods Two cases of AN removal via retrosigmoid approach were reviewed. Hearing preservation was attempted in the aid of endoscopic technique along with continuous monitoring of the compound action potential (CAP) and auditory brainstem response(ABR) during the surgery. Results The tumor in Case 1 was 1.5 cm in diameter. The average pure-tone hearing threshold was 30 dB HL and ABR was normal. Waves I, III and V of ABR were present following tumor removal. At 7th month follow-up, audiometric thresholds and ABR inter-peak intervals had recovered to pre-operative levels, with normal facial nerve function. The patient in Case 2 had bilateral AN. The tumors measured 4.0 cm(left) and 5.0 cm (right) on MRI scans. The AN on the right side was removed first, followed by removal of the left AN four months later. Intraoperative CAP monitoring was employed during removal of the left AN. While efforts to preserve the cochlear nerve were not successful, CAPs were still present after tumor removal. Conclusions Intraoperatively recorded CAPs are not reliable in predicting postoperative hearing outcomes. In contrast, ABRs are an indicator of function of the peripheral auditory pathway. Presence of waves I, III and V following tumor removal may represent preservation of useful hearing.展开更多
Acoustic Neuroma (AN) arises from the eighth cranial nerve. It primarily involves the vestibular branch of the nerve and is therefore also called vestibular schwannoma(VS). To the date, diagnosis and surgical treatmen...Acoustic Neuroma (AN) arises from the eighth cranial nerve. It primarily involves the vestibular branch of the nerve and is therefore also called vestibular schwannoma(VS). To the date, diagnosis and surgical treatment of AN have advanced significantly. Along with advances in audiology and imaging technologies, cases of diagnosed AN have been increasing, making it a common展开更多
The present report should summarize our experience using minimally invasive techniques in acoustic neurinoma surgery at the Neurosurgical Department, University of Vienna, Austria. Based on the experience of about 687...The present report should summarize our experience using minimally invasive techniques in acoustic neurinoma surgery at the Neurosurgical Department, University of Vienna, Austria. Based on the experience of about 687 cases in a 20 year time period our mostly used techniques will be presented. This is a minimal invasive individual adapted approach, specified intraoperative strategy and dissection techniques (e.g. water jet dissection, ultrasonic aspirator CUSA), the use of neuronavigational systems and the use of endoscope assisted surgery. With respect to the limited space of place precise citations to further textbooks of the authors handling with this topic will be given. Finally our results using these techniques are presented and further future perspectives in the treatment of these pathology (radiosurgery) will be discussed.展开更多
Objective: To determine the best follow-up period with regard to curative effect for acoustic neuroma treated with a gamma knife. Methods: Sixty cases of acoustic neuroma were treated with a gamma knife. The follow-up...Objective: To determine the best follow-up period with regard to curative effect for acoustic neuroma treated with a gamma knife. Methods: Sixty cases of acoustic neuroma were treated with a gamma knife. The follow-up period was from 3 to 102 months. Changes in the lesions and peripheral tissues and clinical symptoms were compared and the curative effectiveness of gamma knife treatment was evaluated. Results: The highest total effective rate (92.3%) was in the third period. There was a significant difference in the tumor size postoperatively. There was no edema in the peripheral tissues surrounding the tumor. It was not obvious that clinical symptoms changed. Conclusion: In this report, the best follow-up period was 24-36 months. Gamma knife treatment was still effective after 60 months post-operation.展开更多
The present report summarizes our experience using endoscopes and neuronavigational tech-niques as an assistance in minimally invasive tool in acoustic neurinoma surgery.Based on the experience in about 100cases done ...The present report summarizes our experience using endoscopes and neuronavigational tech-niques as an assistance in minimally invasive tool in acoustic neurinoma surgery.Based on the experience in about 100cases done during the last5years using these additional techniques the significant benefit by using both techniques could be proven as absolutely helpful.In our patient collective until now no compli-cations could been detected regarding the use of these options as well as the effectiveness was from very high value.These,for one hand in detecting residual tumor as well as the possibility of controlling the re-sult after the resection using rigid angled endoscopes and for the other hand by the clear efficiency in us-ing neuronavigational systems in planning and performing the approach as well as doing safety drilling by removing the posterior part of the inner auditory channel.Special remarks and recommendations of the technical equipment which has been used are given as well as personal experiences in the operating room set up.Based on our results and experience the use of this two well known techniques in addition to well trained microsurgical techniques can be highly recommended.展开更多
Objective To evaluate the long-term facial nerve funtion of patients following microsurgical removal of large and huge acoustic neuroma,and to indentify the factors that influence these outcomes. Methods A retrospecti...Objective To evaluate the long-term facial nerve funtion of patients following microsurgical removal of large and huge acoustic neuroma,and to indentify the factors that influence these outcomes. Methods A retrospective review was performed,which included 176 consecutive patients with a展开更多
文摘Objective This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging(MRI)for short-term postoperative facial nerve function in patients with acoustic neuroma.Methods A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included.Clinical data and raw features from four MRI sequences(T1-weighted,T2-weighted,T1-weighted contrast enhancement,and T2-weighted-Flair images)were analyzed.Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features.Nomogram,machine learning,and convolutional neural network(CNN)models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate model performance.A total of 1050 radiomic parameters were extracted,from which 13 radiomic and 3 clinical features were selected.Results The CNN model performed best among all prediction models in the test set with an area under the curve(AUC)of 0.89(95%CI,0.84–0.91).Conclusion CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma.As such,CNN modeling may serve as a potential decision-making tool for neurosurgery.
文摘Objective To report the authors' experiences in hearing preservation during acoustic neuroma (AN) resection procedures. Methods Two cases of AN removal via retrosigmoid approach were reviewed. Hearing preservation was attempted in the aid of endoscopic technique along with continuous monitoring of the compound action potential (CAP) and auditory brainstem response(ABR) during the surgery. Results The tumor in Case 1 was 1.5 cm in diameter. The average pure-tone hearing threshold was 30 dB HL and ABR was normal. Waves I, III and V of ABR were present following tumor removal. At 7th month follow-up, audiometric thresholds and ABR inter-peak intervals had recovered to pre-operative levels, with normal facial nerve function. The patient in Case 2 had bilateral AN. The tumors measured 4.0 cm(left) and 5.0 cm (right) on MRI scans. The AN on the right side was removed first, followed by removal of the left AN four months later. Intraoperative CAP monitoring was employed during removal of the left AN. While efforts to preserve the cochlear nerve were not successful, CAPs were still present after tumor removal. Conclusions Intraoperatively recorded CAPs are not reliable in predicting postoperative hearing outcomes. In contrast, ABRs are an indicator of function of the peripheral auditory pathway. Presence of waves I, III and V following tumor removal may represent preservation of useful hearing.
文摘Acoustic Neuroma (AN) arises from the eighth cranial nerve. It primarily involves the vestibular branch of the nerve and is therefore also called vestibular schwannoma(VS). To the date, diagnosis and surgical treatment of AN have advanced significantly. Along with advances in audiology and imaging technologies, cases of diagnosed AN have been increasing, making it a common
文摘The present report should summarize our experience using minimally invasive techniques in acoustic neurinoma surgery at the Neurosurgical Department, University of Vienna, Austria. Based on the experience of about 687 cases in a 20 year time period our mostly used techniques will be presented. This is a minimal invasive individual adapted approach, specified intraoperative strategy and dissection techniques (e.g. water jet dissection, ultrasonic aspirator CUSA), the use of neuronavigational systems and the use of endoscope assisted surgery. With respect to the limited space of place precise citations to further textbooks of the authors handling with this topic will be given. Finally our results using these techniques are presented and further future perspectives in the treatment of these pathology (radiosurgery) will be discussed.
文摘Objective: To determine the best follow-up period with regard to curative effect for acoustic neuroma treated with a gamma knife. Methods: Sixty cases of acoustic neuroma were treated with a gamma knife. The follow-up period was from 3 to 102 months. Changes in the lesions and peripheral tissues and clinical symptoms were compared and the curative effectiveness of gamma knife treatment was evaluated. Results: The highest total effective rate (92.3%) was in the third period. There was a significant difference in the tumor size postoperatively. There was no edema in the peripheral tissues surrounding the tumor. It was not obvious that clinical symptoms changed. Conclusion: In this report, the best follow-up period was 24-36 months. Gamma knife treatment was still effective after 60 months post-operation.
文摘The present report summarizes our experience using endoscopes and neuronavigational tech-niques as an assistance in minimally invasive tool in acoustic neurinoma surgery.Based on the experience in about 100cases done during the last5years using these additional techniques the significant benefit by using both techniques could be proven as absolutely helpful.In our patient collective until now no compli-cations could been detected regarding the use of these options as well as the effectiveness was from very high value.These,for one hand in detecting residual tumor as well as the possibility of controlling the re-sult after the resection using rigid angled endoscopes and for the other hand by the clear efficiency in us-ing neuronavigational systems in planning and performing the approach as well as doing safety drilling by removing the posterior part of the inner auditory channel.Special remarks and recommendations of the technical equipment which has been used are given as well as personal experiences in the operating room set up.Based on our results and experience the use of this two well known techniques in addition to well trained microsurgical techniques can be highly recommended.
文摘Objective To evaluate the long-term facial nerve funtion of patients following microsurgical removal of large and huge acoustic neuroma,and to indentify the factors that influence these outcomes. Methods A retrospective review was performed,which included 176 consecutive patients with a
