Download PDF
J Neurol Surg B Skull Base 2021; 82(02): 251-257
DOI: 10.1055/s-0039-1697026
Original Article

Can an Imaging Marker of Consistency Predict Intraoperative Experience and Clinical Outcomes for Vestibular Schwannomas? A Retrospective Review

Robert J. Macielak
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Michael S. Harris
2   Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
,
Jameson K. Mattingly
3   Department of Otolaryngology – Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Varun S. Shah
4   College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Luciano M. Prevedello
5   Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Oliver F. Adunka
3   Department of Otolaryngology – Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
› Author Affiliations Support This work was supported by The Ohio State University College of Medicine Bennett research scholarship (RJM).
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective The main purpose of this article is to determine if vestibular schwannoma consistency as determined by tissue intensity on T2-weighted magnetic resonance imagings (MRIs) is predictive of intraoperative experience and postoperative clinical outcomes.

Study Design Retrospective chart review.

Setting Tertiary referral center.

Patients Seventy-seven patients diagnosed with vestibular schwannomas who were treated with microsurgical resection.

Intervention Diagnostic.

Main Outcome Measures Intraoperative measures include totality of resection, surgical time and cranial nerve VII stimulation and postoperative measures include House–Brackmann grade and perioperative complications.

Results Tumor consistency determined via tissue intensity on MRI was only found to correlate with surgical time, with a softer tumor being associated with a longer surgical time (p < 0.0001). However, this was primarily driven by tumor volume with larger tumors being associated with longer surgical time based on multivariate analysis. None of the other intraoperative or postoperative measures considered were found to correlate with tumor consistency.

Conclusions Tumor consistency determined by MRI is not predictive of intraoperative experience or postoperative outcomes in vestibular schwannomas. Tumor volume is the strongest driver of these outcome measures as opposed to tumor consistency.

Keywords

vestibular schwannoma - consistency - clinical outcomes


Publication History

Received: 03 February 2019

Accepted: 28 July 2019

Article published online:
24 September 2019

© 2019. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Matthies C, Samii M. Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurgery 1997; 40 (01) 1-9 , discussion 9–10
    PubMedSearch in Google Scholar
  • 2 Carlson ML, Habermann EB, Wagie AE. et al. The changing landscape of vestibular schwannoma management in the United States--a shift toward conservatism. Otolaryngol Head Neck Surg 2015; 153 (03) 440-446
    CrossrefPubMedSearch in Google Scholar
  • 3 Carlson ML, Tveiten OV, Driscoll CL. et al. Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls. J Neurosurg 2015; 122 (04) 833-842
    CrossrefPubMedSearch in Google Scholar
  • 4 Carlson ML, Link MJ, Wanna GB, Driscoll CL. Management of sporadic vestibular schwannoma. Otolaryngol Clin North Am 2015; 48 (03) 407-422
    CrossrefPubMedSearch in Google Scholar
  • 5 Carlson ML, Vivas EX, McCracken DJ. et al. Congress of neurological surgeons systematic review and evidence-based guidelines on hearing preservation outcomes in patients with sporadic vestibular schwannomas. Neurosurgery 2018; 82 (02) E35-E39
    CrossrefPubMedSearch in Google Scholar
  • 6 Carlson ML, Van Gompel JJ, Wiet RM. et al. A cross-sectional survey of the North American Skull Base Society: current practice patterns of vestibular schwannoma evaluation and management in North America. J Neurol Surg B Skull Base 2018; 79 (03) 289-296
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Di Maio S, Akagami R. Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas. J Neurosurg 2009; 111 (04) 855-862
    CrossrefPubMedSearch in Google Scholar
  • 8 Lau T, Olivera R, Miller Jr T. et al. Paradoxical trends in the management of vestibular schwannoma in the United States. J Neurosurg 2012; 117 (03) 514-519
    CrossrefPubMedSearch in Google Scholar
  • 9 Pollock BE, Driscoll CL, Foote RL. et al. Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 2006; 59 (01) 77-85 , discussion 77–85
    CrossrefPubMedSearch in Google Scholar
  • 10 Strasnick B, Glasscock III ME, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope 1994; 104 (09) 1115-1119
    CrossrefPubMedSearch in Google Scholar
  • 11 Gerganov VM, Klinge PM, Nouri M, Stieglitz L, Samii M, Samii A. Prognostic clinical and radiological parameters for immediate facial nerve function following vestibular schwannoma surgery. Acta Neurochir (Wien) 2009; 151 (06) 581-587 , discussion 587
    CrossrefPubMedSearch in Google Scholar
  • 12 Kazim SF, Shamim MS, Enam SA, Bari ME. Microsurgical excisions of vestibular schwannomas: a tumor-size-based analysis of neurological outcomes and surgical complications. Surg Neurol Int 2011; 2: 41
    CrossrefPubMedSearch in Google Scholar
  • 13 Post KD, Eisenberg MB, Catalano PJ. Hearing preservation in vestibular schwannoma surgery: what factors influence outcome?. J Neurosurg 1995; 83 (02) 191-196
    CrossrefPubMedSearch in Google Scholar
  • 14 Sanna M, Taibah A, Russo A, Falcioni M, Agarwal M. Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery. Otol Neurotol 2004; 25 (03) 379-386
    CrossrefPubMedSearch in Google Scholar
  • 15 Sepehrnia A, Borghei-Razavi H. Vestibular schwannoma between 1 and 3 cm: importance of the tumor size in surgical and functional outcome. Clin Neurol Neurosurg 2015; 129: 21-26
    CrossrefPubMedSearch in Google Scholar
  • 16 Sharma M, Sonig A, Ambekar S, Nanda A. Radiological and clinical factors predicting the facial nerve outcome following retrosigmoid approach for large vestibular schwannomas (VSs). J Neurol Surg B Skull Base 2013; 74 (05) 317-323
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Copeland WR, Hoover JM, Morris JM, Driscoll CL, Link MJ. Use of preoperative MRI to predict vestibular schwannoma intraoperative consistency and facial nerve outcome. J Neurol Surg B Skull Base 2013; 74 (06) 347-350
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Rizk AR, Adam A, Gugel I, Schittenhelm J, Tatagiba M, Ebner FH. Implications of vestibular schwannoma consistency: analysis of 140 cases regarding radiologic and clinical features. World Neurosurg 2017; 99: 159-163
    CrossrefPubMedSearch in Google Scholar
  • 19 Alyamany M, Alshardan MM, Jamea AA, ElBakry N, Soualmi L, Orz Y. Meningioma consistency: correlation between magnetic resonance imaging characteristics, operative findings, and histopathological features. Asian J Neurosurg 2018; 13 (02) 324-328
    Thieme ConnectPubMedSearch in Google Scholar
  • 20 Smith KA, Leever JD, Chamoun RB. Predicting consistency of meningioma by magnetic resonance imaging. J Neurol Surg B Skull Base 2015; 76 (03) 225-229
    Thieme ConnectPubMedSearch in Google Scholar
  • 21 Smith KA, Leever JD, Hylton PD, Camarata PJ, Chamoun RB. Meningioma consistency prediction utilizing tumor to cerebellar peduncle intensity on T2-weighted magnetic resonance imaging sequences: TCTI ratio. J Neurosurg 2017; 126 (01) 242-248
    CrossrefPubMedSearch in Google Scholar
  • 22 Yao A, Pain M, Balchandani P, Shrivastava RK. Can MRI predict meningioma consistency? A correlation with tumor pathology and systematic review. Neurosurg Rev 2018; 41 (03) 745-753
    CrossrefPubMedSearch in Google Scholar
  • 23 Neff BA, Ting J, Dickinson SL, Welling DB. Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol 2005; 26 (04) 728-732
    CrossrefPubMedSearch in Google Scholar
  • 24 Hughes JD, Fattahi N, Van Gompel J. et al. Higher-resolution magnetic resonance elastography in meningiomas to determine intratumoral consistency. Neurosurgery 2015; 77 (04) 653-658 , discussion 658–659
    CrossrefPubMedSearch in Google Scholar
  • 25 Murphy MC, Huston III J, Glaser KJ. et al. Preoperative assessment of meningioma stiffness using magnetic resonance elastography. J Neurosurg 2013; 118 (03) 643-648
    CrossrefPubMedSearch in Google Scholar