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内耳道内及前庭神经鞘瘤切除与人工耳蜗植入后的MRI观察

MRI Observation After Intralabyrinthine and Vestibular Schwannoma Resection and Cochlear Implantation.

作者信息

Sudhoff Holger, Gehl Hans B, Scholtz Lars U, Todt Ingo

机构信息

Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld University, Bielefeld, Germany.

Department of Radiology, Klinikum Bielefeld, Bielefeld, Germany.

出版信息

Front Neurol. 2020 Aug 12;11:759. doi: 10.3389/fneur.2020.00759. eCollection 2020.

Abstract

MRI observation is part of the regular follow-up after vestibular schwannoma (VS) or intralabyrinthine schwannoma (ILS) resection. Because cochlear implantation (CI) after resection is part of the audiological rehabilitation process, the magnet resonance imaging (MRI) behavior of CI systems needs to be considered. In light of recent developments in MRI artifact positioning and pain prevention, this study evaluates reproducible MRI observations after tumor resection and CI surgery as part of follow-up. In a retrospective study, we evaluated 9 patients with a T1 KM, T2 sequence MRI observation, and cone beam computed tomography (CBCT) after ILS/VS resection and CI. In all but one case, a CI with a diametrically bipolar magnet and a receiver positioned 8-9 cm behind the external auditory canal was performed. In all but one case, MRI observation allowed for a pain-free visual assessment of the intralabyrinthine and internal auditory canal (IAC) regions. In one case, a painful dislodgement of the receiver magnet occurred. MRI follow-up after ILS and VS resection and CI is reproducibly possible. Implant choice and positioning should be considered before implantation to allow for a pain-free visual assessment afterward. This finding allows for the first time a widening of the indication into this patient group.

摘要

磁共振成像(MRI)观察是前庭神经鞘瘤(VS)或迷路内神经鞘瘤(ILS)切除术后常规随访的一部分。由于切除术后的人工耳蜗植入(CI)是听力康复过程的一部分,因此需要考虑CI系统的磁共振成像(MRI)表现。鉴于MRI伪影定位和疼痛预防方面的最新进展,本研究评估了肿瘤切除和CI手术后作为随访一部分的可重复性MRI观察结果。在一项回顾性研究中,我们评估了9例ILS/VS切除和CI术后进行T1加权像、T2序列MRI观察及锥形束计算机断层扫描(CBCT)的患者。除1例患者外,其余所有患者均植入了直径双极磁体且接收器位于外耳道后方8-9厘米处的CI。除1例患者外,其余所有患者的MRI观察均能对迷路内和内耳道(IAC)区域进行无痛视觉评估。有1例患者出现了接收器磁体的疼痛性移位。ILS和VS切除及CI术后的MRI随访具有可重复性。植入前应考虑植入物的选择和定位,以便术后能进行无痛视觉评估。这一发现首次扩大了该患者群体的适应症范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b4a/7434924/1395570c680b/fneur-11-00759-g0001.jpg

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