{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T04:26:55Z","timestamp":1770956815606,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the predictive value of plasma matrix metalloproteinase\u20109 (MMP\u20109) level in determining the extent of tumor resection (EOR) and tumor adherence in vestibular schwannoma (VS) surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma and tumor samples were prospectively collected from patients with nonradiated, sporadic VS undergoing microsurgical resection from July 2022 to June 2023. Plasma MMP\u20109 levels were measured by enzyme\u2010linked immunosorbent assay, and their association with tumor adherence and postoperative outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three patients undergoing microsurgical resection agreed to participate (15 females, median age 54 years old, median tumor size 26.7\u2009mm). A gross total resection (GTR) was performed in 18 patients (55%), and a near\u2010total (NTR)\/subtotal resection (STR) in 15 (45%). Tumor size was not significantly different between the GTR and NTR\/STR groups (20.7 vs 24.8\u2009mm, <jats:italic>P<\/jats:italic>=\u2009.185). Intraoperatively, a larger fraction of NTR\/STR tumors were highly adherent to the brainstem and\/or cranial nerves (93% vs 56%, <jats:italic>P<\/jats:italic>\u2009=\u2009.015). Preoperative plasma MMP\u20109 was higher in patients who underwent an NTR\/STR compared to a GTR (229.9 vs 131.2ng\/mL, P\u2009=\u2009.007). On multivariable logistic regression, preoperative plasma MMP\u20109 strongly predicted EOR by receiver operating characteristic analysis (area under the curve [AUC]\u2009=\u20090.77 P\u2009=\u2009.008). Combining plasma MMP\u20109 and age was an excellent predictor of EOR (AUC\u2009=\u20090.91, P\u2009=\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Plasma MMP\u20109 levels strongly predicted intraoperative tumor adherence and postoperative extent of resection. This could provide crucial preoperative insights into surgical difficulty, potential complications, and the likelihood of gross total tumor removal, enhancing informed decision\u2010making for both physicians\/surgeons and patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1138","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T01:37:23Z","timestamp":1737423443000},"page":"1379-1386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Plasma Matrix Metalloproteinase\u20109 Predicts Intraoperative Experience and Extent of Resection in Vestibular Schwannoma Surgery"],"prefix":"10.1002","volume":"172","author":[{"given":"Han T.N.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio 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