Use of DTT to define facial nerve position in vestibular schwannomas
Research type
Research Study
Full title
The accuracy of advanced probabilistic diffusion tensor tractography (DTT) for the pre-operative identification of facial nerve position in patients with extrameatal vestibular schwannomas.
IRAS ID
226479
Contact name
Steve Connor
Contact email
Sponsor organisation
King's College Hospital
Clinicaltrials.gov Identifier
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Vestibular schwannomas (VS) arise from the vestibulocochlear (hearing and balance) nerve, located at the base of the brain. Although benign, VS can enlarge over time, resulting in debilitating symptoms; therefore, surgical removal is frequently offered. One significant risk of surgery is inadvertent injury to the facial nerve, which lies adjacent to the vestibulocochlear nerve. Currently, the nerve’s course is only revealed during surgical dissection and injury can cause permanent facial weakness. It would therefore be useful for the surgeon to know the course of the nerve before operating. To this end, a new MRI technique known as probabilistic diffusion tensor tractography (DTT) has shown potential in revealing the course of the facial nerve pre-operatively. However, its clinical reliability remains uncertain.
This study aims to investigate the reliability of DTT in identifying the course of the facial nerve preoperatively in patients undergoing surgery for VS.
The future benefit would be to enable surgeons to operate with more confidence and potentially reduce the chance of nerve injury.
The study will recruit adult patients due to have surgery for VS. The only change to the participants’ clinical pathways will be the addition of a DTT sequence to their pre-operative MRI scans (increasing scanning time by approximately 10 minutes).
The radiology team will create a database of the facial nerve positions as determined by DTT. The neurosurgical team will be blind to these results and will create a separate database, which will contain the recorded facial nerve positions at surgery. The latter will represent the gold standard. The two databases will be compared at the end of the study to determine the accuracy of DTT.
Recruitment and imaging will take place at King's College and Guy’s and St. Thomas’ Hospitals NHS Foundation Trusts, respectively.
REC name
London - Dulwich Research Ethics Committee
REC reference
19/LO/0428
Date of REC Opinion
27 Mar 2019
REC opinion
Favourable Opinion