INTRODUCTION: Currently, it is possible to preserve the auditory nerve in a large number of cases, but the preservation of the hearing itself is unpredictable. Apart from wait and scan strategy and stereoradiotherapy, hearing after vestibular schwannoma surgery is considered to remain stable even in long-term follow-up. MATERIALS AND METHODS: Twenty-eight patients had preserved hearing after retrosigmoid suboccipital microsurgery of the vestibular schwannoma between 2008 and 2014. A standard audiological protocol was performed together with an magnetic resonance imaging evaluation of the fluid content of the inner ear. RESULTS: The mean difference in pure-tone average between the direct and final postsurgical examination was 12.758 dB ( p = 2.5E - 06). The word recognition score deteriorated by 17.45% ( p = 0.03516). The mean American Academy of Otolaryngology-Head and Neck Surgery score on the second examination was 2.5, and that on the second examination was 3.111 ( p = 0.00483). There was no significant deterioration in the healthy ear.The signal intensity ratio in the basal turn of the cochlea increased by an average of 0.13 points ( p < 0.05).Patients with persistent tumor or nodular enhancement in the internal acoustic meatus deteriorated significantly in hearing according to the American Academy of Otolaryngology-Head and Neck Surgery scale compared with patients without any finding in the meatus ( p = 0.01299). CONCLUSIONS: There is a discrete but gradual deterioration of the hearing in the postoperative period. Hearing impairment is more pronounced in patients with a nodular process in the internal acoustic meatus, regardless of whether it is growth active. After surgery, the pathological content of the inner ear normalizes (evaluated on T2 magnetic resonance imaging sequences).
- MeSH
- kochlea MeSH
- lidé MeSH
- nedoslýchavost * etiologie MeSH
- retrospektivní studie MeSH
- sluch MeSH
- vestibulární schwannom * chirurgie MeSH
- vnitřní ucho * chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECT: To evaluate the potential of quantitative MR techniques [voxel-based morphometry (VBM), T2-relaxometry, mean diffusivity (MD), fractional anisotropy (FA)] in the diagnostics of amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS: Thirty-three ALS patients and thirty age- and sex-matched healthy volunteers were included in the cross-sectional study. T1WI, T2WI and T2 relaxometry sequences were performed at 1.5T. DWI was performed in a subgroup of 12 patients. Disease severity was estimated with the ALS Functional Rating Scale (ALS-FRS). RESULTS: We detected decreased T2 relaxation rate (R2) in the frontal white matter (FWM) (left and right P < 0.005) and caudate nucleus (left P < 0.005) in ALS patients. R2 in the FWM correlated with age in patients and controls. A correlation (P < 0.01, cluster-level corrected) between atrophy in the corona radiata and the limb ALS-FRS subset was found, as well as a difference between patients and controls in this area. No correlation between FA/MD and ALS-FRS was observed in the T2 hyperintense region of the posterior limb of the internal capsule (PLIC), or in the site of atrophy detected by VBM. No R2 or PD changes in the PLIC were detected. TBSS revealed decreased FA in the corona radiata and callosal body. CONCLUSIONS: Decreased R2 in the left caudate and bilateral FWM may help in the diagnostic process and disqualifies these regions as internal controls in ALS studies. The PLIC is not a reliable diagnostic marker of ALS.
- MeSH
- amyotrofická laterální skleróza diagnóza MeSH
- difuzní magnetická rezonance metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozek patologie MeSH
- průřezové studie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH