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Tytuł pozycji:

Computed tomography's ability to predict sacrifice of hypoglossal nerve at resection.

Tytuł:
Computed tomography's ability to predict sacrifice of hypoglossal nerve at resection.
Autorzy:
Dubin MG; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 27599-7070, USA. />Ebert CS
Mukherji SK
Pollock HW
Amjadi D
Shockley WW
Źródło:
The Laryngoscope [Laryngoscope] 2002 Dec; Vol. 112 (12), pp. 2181-5.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell
Original Publication: St. Louis, Mo. : [s.n., 1896-
MeSH Terms:
Hypoglossal Nerve*/surgery
Tomography, X-Ray Computed*
Mouth Neoplasms/*surgery
Female ; Humans ; Male ; Mouth Neoplasms/diagnostic imaging ; Predictive Value of Tests ; Preoperative Care ; Sensitivity and Specificity
Entry Date(s):
Date Created: 20021204 Date Completed: 20030102 Latest Revision: 20161124
Update Code:
20220902
DOI:
10.1097/00005537-200212000-00010
PMID:
12461337
Czasopismo naukowe
Objective: To assess whether preoperative computed tomography (CT) scan can determine if the hypoglossal nerve (cranial nerve XII) will be sacrificed in floor-of-mouth, oral tongue, and tongue base tumor resections.
Study Design: Retrospective review.
Methods: Patients who underwent resection of floor-of-mouth, oral tongue, and tongue base tumors from 1990 to 1999 were identified. Preoperative CT scans were reviewed by a neuroradiologist. The postoperative status of cranial nerve XII was predicted to be "saved" or "sacrificed." Hypoglossal nerve "sacrifice" was predicted if the fat planes surrounding the takeoff of the proximal lingual artery were obliterated by tumor. The nerve was determined to be sacrificed or spared during resection by review of the operative report.
Results: Of the 45 patients, 14 tumors were predicted radiographically to involve the hypoglossal nerve. Twenty-seven of 31 nerves that were predicted to be saved were saved at the time of surgery. Seven of 14 nerves that were predicted to be sacrificed were sacrificed at the time of surgery. The sensitivity was 0.64 (95% confidence interval [CI], 0.35-0.86) with a specificity of 0.79 (95% CI, 0.70-0.87). The positive predictive value was 0.50 (95% CI, 0.27-0.68) with a negative predictive value of 0.87 (95% CI, 0.77-0.95).
Conclusions: The ability to predict preoperatively whether a tumor can be resected without sacrificing the hypoglossal nerve would be an important factor in determining management of these tumors. The results indicate that CT scan accurately predicts the ability of the surgeon to spare the hypoglossal nerve (negative predictive value, 87%) with a specificity of 0.79.

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