CORRESPONDENCE Disclosure Letter: Visualization of Cranial Nerves Using The authors have no personal, financial, or institutional interest in any of the High-Definition Fiber Tractography drugs, materials, or devices described in this article. To the Editor: We read with great interest the article by Masanori Yoshino Kaichuang Yang, MS et al in the July issue of Neurosurgery entitled “Visualization Tejashwi Shrestha, MD of Cranial Nerves Using High-Definition Fiber Tractography.” Manish Kolakshyapati, MD As we know, several researchers have tried diffusion tensor Department of Neurosurgery, imaging, fast imaging employing steady-state acquisition, and ZheJiang Provincial People’s Hospital, 3-dimensional anisotropy contrast-periodically rotated Hangzhou, China overlapping parallel lines with enhanced reconstruction imaging Department of Clinical Neuroscience and Therapeutics, to detect or simulate neural tracts and nuclei in the brainstem 2-4 Graduate School of Biomedical and Health Sciences, recently. Several researchers have reported successful recon- Hiroshima University, struction of the cisternal portions of Cranial Nerve (CN) VI Hiroshima, Japan in their reports. But to our best knowledge, simulation of the Department of Neurosurgery, entire cisternal portions of CN VI if it is compressed by a very Graduate School of Biomedical and Health Sciences, large petroclival meningioma or encased in the tumor is not 1 Hiroshima University, well reported. We greatly appreciate Masanori Yoshino et al for Hiroshima, Japan reconstructing the petroclival portions of CN VI in some cases using high-definition fiber tractography (HDFT), which is a Correspondence: great breakthrough. It will be very helpful for neurosurgeons to Manish Kolakshyapati, MD, Department of Neurosurgery, minimize the injury and protect the abducens nerve during the Graduate School of Biomedical and Health Sciences, Hiroshima surgery. We would be grateful to Masanori Yoshino et al if they University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, could provide more details regarding a few of our concerns. In Japan. E-mail: email@example.com cases of large petroclival meningioma, the abducens nerve may be compressed in varying proportions and in some cases may be enclosed within the tumor. In such cases, the nerve fibers may REFERENCES be distorted or even invaded by the tumor. In such a case, would it be possible to reconstruct the course of the nerve by using 1. Yoshino M, Abhinav K, Yeh FC, et al. Visualization of cranial nerves using high- definition fiber tractography. Neurosurgery. 2016;79(1):146-165. HDFT? Also in a case in which the abducens nerve is encased 2. Yamasaki F, Akiyama Y, Tsumura R, et al. Post-traumatic unilateral avulsion of by a large tumor, is it possible to simulate the entire portion of the abducens nerve with damage to cranial nerves VII and VIII: case report. NMC the nerve within the tumor? If these could be solved, it would Case Rep J. 2016;3(3):81-83. 3. Nishikawa T, Okamoto K, Matsuzawa H, Terumitsu M, Nakada T, Fujii be a good advancement in the field of neuroimaging and would Y. Detectability of neural tracts and nuclei in the brainstem utilizing 3DAC- definitely improve the postoperative outcome of the patients. PROPELLER. J Neuroimaging. 2014;24(3):238-244. 4. Jun M, Shaobo S, Shuyuan Y, et al. Preoperative visualization of cranial nerves in skull base tumor surgery using diffusion tensor imaging technology. Turk Neurosurg. 2016;26(6):805-512. ABBREVIATIONS: CN, Cranial Nerve; HDFT, high- definition fiber tract-ography 10.1093/neuros/nyw167 NEUROSURGERY VOLUME 80 | NUMBER 5 | MAY 2017 | E251
Neurosurgery – Oxford University Press
Published: May 1, 2017
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