Clinical trial · Interventional
Use of DTT to Define Facial Nerve Position in Vestibular Schwannomas
The Accuracy of Advanced Probabilistic Diffusion Tensor Tractography (DTT) for the Pre-operative Identification of Facial Nerve Position in Patients With Extrameatal Vestibular Schwannomas.
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
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).
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Vestibular Schwannoma | Vestibular Schwannoma | ONTOLOGY_EXACT | 0.98 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Probabilistic diffusion tensor tractography | Diagnostic Test | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Patients having pre-operative DTT prior to surgery
- description
- All patients in this study will undergo DTT as part of a pre-operative MRI.
- interventionNames
- Diagnostic Test: Probabilistic diffusion tensor tractography
Primary outcomes (1)
- measure
- Accuracy of probabilistic diffusion tensor tractography (DTT)
- timeFrame
- 4 years
- description
- To assess the accuracy of pre-operative probabilistic DTT in determining the position of the facial nerve (relative to extrameatal portion of a vestibular schwannoma) by using the facial nerve position at surgery as a reference standard.
Secondary outcomes (6)
- measure
- Reproducibility
- timeFrame
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * The capacity to understand the patient information sheet and the ability to provide written informed consent * \>1.5cm extrameatal tumor determined to represent a vestibular schwannoma by preoperative imaging * HB grade I or II preoperatively Exclusion Criteria: * Patients not meeting the above inclusion criteria * Standard contraindications to MRI * Previous cranial radiotherapy or previous surgery to the cerebellopontine angle cistern or IAM
References
Publications (9)
- BACKGROUNDCauley KA, Filippi CG. Diffusion-tensor imaging of small nerve bundles: cranial nerves, peripheral nerves, distal spinal cord, and lumbar nerve roots--clinical applications. AJR Am J Roentgenol. 2013 Aug;201(2):W326-35. doi: 10.2214/AJR.12.9230. PMID 23883249
- BACKGROUNDChoi KS, Kim MS, Kwon HG, Jang SH, Kim OL. Preoperative identification of facial nerve in vestibular schwannomas surgery using diffusion tensor tractography. J Korean Neurosurg Soc. 2014 Jul;56(1):11-5. doi: 10.3340/jkns.2014.56.1.11. Epub 2014 Jul 31. PMID 25289119
- BACKGROUNDGerganov VM, Giordano M, Samii M, Samii A. Diffusion tensor imaging-based fiber tracking for prediction of the position of the facial nerve in relation to large vestibular schwannomas. J Neurosurg. 2011 Dec;115(6):1087-93. doi: 10.3171/2011.7.JNS11495. Epub 2011 Aug 26. PMID 21962081
- BACKGROUNDMukherjee P, Berman JI, Chung SW, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: theoretic underpinnings. AJNR Am J Neuroradiol. 2008 Apr;29(4):632-41. doi: 10.3174/ajnr.A1051. Epub 2008 Mar 13. PMID 18339720
- BACKGROUNDSampath P, Rini D, Long DM. Microanatomical variations in the cerebellopontine angle associated with vestibular schwannomas (acoustic neuromas): a retrospective study of 1006 consecutive cases. J Neurosurg. 2000 Jan;92(1):70-8. doi: 10.3171/jns.2000.92.1.0070. PMID 10616085
- BACKGROUNDSong F, Hou Y, Sun G, Chen X, Xu B, Huang JH, Zhang J. In vivo visualization of the facial nerve in patients with acoustic neuroma using diffusion tensor imaging-based fiber tracking. J Neurosurg. 2016 Oct;125(4):787-794. doi: 10.3171/2015.7.JNS142922. Epub 2016 Jan 1. PMID 26722859
- BACKGROUNDTaoka T, Hirabayashi H, Nakagawa H, Sakamoto M, Myochin K, Hirohashi S, Iwasaki S, Sakaki T, Kichikawa K. Displacement of the facial nerve course by vestibular schwannoma: preoperative visualization using diffusion tensor tractography. J Magn Reson Imaging. 2006 Nov;24(5):1005-10. doi: 10.1002/jmri.20725.