A multi-institutional machine learning algorithm for prognosticating facial nerve injury following microsurgical resection of vestibular schwannoma.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
05 06 2024
Historique:
received: 18 11 2023
accepted: 26 05 2024
medline: 6 6 2024
pubmed: 6 6 2024
entrez: 5 6 2024
Statut: epublish

Résumé

Vestibular schwannomas (VS) are the most common tumor of the skull base with available treatment options that carry a risk of iatrogenic injury to the facial nerve, which can significantly impact patients' quality of life. As facial nerve outcomes remain challenging to prognosticate, we endeavored to utilize machine learning to decipher predictive factors relevant to facial nerve outcomes following microsurgical resection of VS. A database of patient-, tumor- and surgery-specific features was constructed via retrospective chart review of 242 consecutive patients who underwent microsurgical resection of VS over a 7-year study period. This database was then used to train non-linear supervised machine learning classifiers to predict facial nerve preservation, defined as House-Brackmann (HB) I vs. facial nerve injury, defined as HB II-VI, as determined at 6-month outpatient follow-up. A random forest algorithm demonstrated 90.5% accuracy, 90% sensitivity and 90% specificity in facial nerve injury prognostication. A random variable (rv) was generated by randomly sampling a Gaussian distribution and used as a benchmark to compare the predictiveness of other features. This analysis revealed age, body mass index (BMI), case length and the tumor dimension representing tumor growth towards the brainstem as prognosticators of facial nerve injury. When validated via prospective assessment of facial nerve injury risk, this model demonstrated 84% accuracy. Here, we describe the development of a machine learning algorithm to predict the likelihood of facial nerve injury following microsurgical resection of VS. In addition to serving as a clinically applicable tool, this highlights the potential of machine learning to reveal non-linear relationships between variables which may have clinical value in prognostication of outcomes for high-risk surgical procedures.

Identifiants

pubmed: 38839778
doi: 10.1038/s41598-024-63161-1
pii: 10.1038/s41598-024-63161-1
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

12963

Subventions

Organisme : NIH HHS
ID : T32NS091006-07
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Sabrina M Heman-Ackah (SM)

Department of Neurosurgery, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 15th Floor, Philadelphia, PA, 19104, USA. sabrina.heman-ackah@pennmedicine.upenn.edu.
Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA. sabrina.heman-ackah@pennmedicine.upenn.edu.

Rachel Blue (R)

Department of Neurosurgery, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 15th Floor, Philadelphia, PA, 19104, USA.

Alexandra E Quimby (AE)

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University Hospital, Syracuse, NY, USA.

Hussein Abdallah (H)

School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Elizabeth M Sweeney (EM)

Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA.

Daksh Chauhan (D)

University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.

Tiffany Hwa (T)

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.

Jason Brant (J)

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.

Michael J Ruckenstein (MJ)

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.

Douglas C Bigelow (DC)

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.

Christina Jackson (C)

Department of Neurosurgery, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 15th Floor, Philadelphia, PA, 19104, USA.

Georgios Zenonos (G)

Center for Cranial Base Surgery, University of Pittsburgh, Pittsburgh, PA, USA.

Paul Gardner (P)

Center for Cranial Base Surgery, University of Pittsburgh, Pittsburgh, PA, USA.

Selena E Briggs (SE)

Department of Otolaryngology, MedStar Washington Hospital Center, Washington, DC, USA.
Department of Otolaryngology, Georgetown University, Washington, DC, USA.

Yale Cohen (Y)

Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.
Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.

John Y K Lee (JYK)

Department of Neurosurgery, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 15th Floor, Philadelphia, PA, 19104, USA.
Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.

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