NÖROTOLOJİK SEMPTOMLARI AÇIKLAMADA 7. - 8. SİNİR KOMPLEKSİ İÇİN VASKÜLER LOOP KOMPRESYONUNUN DEĞERLENDİRİLMESİ NE KADAR ETKİLİDİR ?

Abstract

OBJECTIVE: The goal of this research study was to investigate of whether the radiological proof of neurovascular compression of the vestibulocochlear nerve (VCN) was pathognomonic for hearing loss and tinnitus using “3D Fast Imaging Steady-State Acquisition (FIESTA)” magnetic resonance imaging (MRI) sequence.MATERIAL AND METHODS: The research study was performed in 85 patients by evaluating 170 temporal bones, inclusive of both sides. The non-invasive assessment of the anatomical relationship between the classified vascular compression (Chavda classification) of the anterior inferior cerebellar artery (AICA) and the existence of AICA, superior cerebellar artery (SCA), vertebral artery (VA) compression or distortion of the VCN was applied by using 1.5-Tesla MRI at the internal acoustic canal (IAC).RESULTS: Of the 85 participants examined, 42.4% (n = 36) presented no vascular loop (VL). 48.2% (n = 41) of the patients produced type 1 VL, 8.2% (n = 7) type 2 VL, and 1.2% (n = 1) type 3 VL accordingly to the Chavda classification. In addition, compressions of redundant VA and SCA were also observed in 7.1% (n = 6) and 3.5% (n = 3) of the patients respectively. Also, IAC distortion was found in 32% (n = 16) patients with tinnitus. The presence of vascular loops also showed a high incidence in patients with normal hearing (51.8%) and without tinnitus (62.9%), respectively. No statistically relevant variations were found between the existence and nonexistence of the VL of AICA forms, VA or SCA, and IAC distortion for the neurotological symptoms of patients (p > 0.05).CONCLUSIONS: Neurovascular touch is not an uncommon finding. It doesn’t appear to be related to tinnitus. However, the use of 3D-FIESTA MRI well defines the relationship between VCN and adjacent vascular variations and especially AICA variations and contributes to case selection for microvascular operations.