gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Subperineurial/subcapsular dissection based on the histopathological consideration in vestibular schwannoma surgery

Meeting Abstract

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  • T. Sasaki - Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocMI.05.03

doi: 10.3205/12dgnc014, urn:nbn:de:0183-12dgnc0140

Published: June 4, 2012

© 2012 Sasaki.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.