Artikel
Subperineurial/subcapsular dissection based on the histopathological consideration in vestibular schwannoma surgery
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Autoren
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T. Sasaki
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: The ultimate goal of surgery for vestibular schwannoma (VS) is complete removal of the tumor with preservation of facial and cochlear nerve functions. To achieve this, a cleavage plane must be placed between the tumor tissue and the cranial nerves based on the understanding of the microstructure of the tumor capsules and nerve-tumor interface.
Methods: Detailed histological examinations of the free surfaces of the tumors in the cerebellopontine cistern were performed in 31 cases of unilateral VS and we studied the capsule-tumor tissue interface. We also evaluated the functional outcomes of 310 unilateral VSs operated in accordance with our operative principle of "subperineurial" or "subcapsular" dissection.
Results: At discharge, good facial nerve function (H-B grade 1 or 2) was preserved in 70.1% of the patients. One year after the operation, it improved to 96.7%. Useful hearing was preserved in 50.8% of the patients.
Conclusions: The "subperineurial" or "subcapsular" dissection appeared to increase the likelihood of preserving facial and cochlear nerve functions.
