Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China; International Neuroscience Institute (China-INI), Beijing, China.
Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China; International Neuroscience Institute (China-INI), Beijing, China; Department of Neurosurgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.
World Neurosurg. 2021 Feb;146:351-361.e3. doi: 10.1016/j.wneu.2020.10.136. Epub 2020 Oct 28.
The popularization and application of microscopy, the in-depth study of the microanatomy of the cerebellopontine angle, and the application of intraoperative electrophysiological monitoring technology to preserve facial nerve function have laid a solid foundation for the modern era of neurosurgery. The preoperative prediction of the location of the facial nerve is a long-desired goal of neurosurgeons. The advances in neuroimaging seem to be making this goal a reality. Many studies investigating the reliability of the preoperative prediction of the location of the facial nerve using diffusion tensor imaging-fiber tracking in vestibular schwannoma have been reported in the last 20 years. The PubMed, Embase, and Cochrane databases were searched for articles published before March 30, 2020. A comprehensive review of published studies was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Authors performed a systematic review and meta-analysis of the reported data to assess the reliability of the preoperative prediction of the location of the facial nerve using diffusion tensor imaging-fiber tracking in vestibular schwannoma. The data were analyzed using a fixed-effects model. The estimated overall intraoperative verification concordance rate was 89.05% (95% confidence interval 85.06%-92.58%). Preoperatively predicting the location of the facial nerve using diffusion tensor imaging-fiber tracking in vestibular schwannoma is reliable, but the extent to which it contributes to long-term facial nerve function is still unclear. To further verify these results, studies with larger sample sizes are needed in the future, especially prospective randomized controlled trials focusing on the long-term functional preservation of the facial nerve.
显微镜的普及和应用、对桥小脑角的深入研究以及术中电生理监测技术对面神经功能的保护，为现代神经外科学奠定了坚实的基础。面神经位置的术前预测是神经外科医生长期以来的愿望。神经影像学的进步似乎使这一目标成为现实。过去 20 年来，许多研究探讨了使用弥散张量成像-纤维追踪技术对面神经前庭神经鞘瘤位置进行术前预测的可靠性。在 2020 年 3 月 30 日之前，检索了 PubMed、Embase 和 Cochrane 数据库中的文章。根据系统评价和荟萃分析的首选报告项目，对已发表的研究进行了全面综述。作者对报告的数据进行了系统评价和荟萃分析，以评估弥散张量成像-纤维追踪技术对面神经前庭神经鞘瘤位置进行术前预测的可靠性。使用固定效应模型进行数据分析。估计的总体术中验证一致性率为 89.05%（95%置信区间 85.06%-92.58%）。使用弥散张量成像-纤维追踪技术对面神经前庭神经鞘瘤位置进行术前预测是可靠的，但它对面神经长期功能的影响程度尚不清楚。为了进一步验证这些结果，未来需要进行更大样本量的研究，特别是前瞻性随机对照试验，重点关注面神经的长期功能保护。
