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Vestibular Schwannoma (VS) Surgery: Histological Considerations and Operative Results

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Tumors of the Central Nervous System, Volume 7

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 7))

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Abstract

In vestibular schwannoma (VS) surgery, understanding of the tumor capsules and nerve-tumor interface is very important to achieve extensive tumor removal while preserving facial and cochlear nerve function. We here demonstrate that tumor capsules of VS consist of thin perineurium of the vestibular nerve and remaining vestibular nerve fibers based on our histological examinations. Also, we show our operative concept of “subcapsular” or “subperineurial” dissection to preserve cranial nerve functions. In this procedure, we place the cleavage plane between the tumor capsules and the tumor parenchyma, which enables us to perform nearly total removal of the tumor by tracing this cleavage plane. Finally, we present our surgical outcomes based on this histological consideration, and conclude that we could increase the possibilities of preserving facial and cochlear nerve functions by performing “subcapsular” or “subperineurial” dissection.

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References

  • Ciric I, Zhao JC, Rosenblatt S, Wiet R, O’Shaughnessy B (2005) Suboccipital retrosigmoid approach for removal of vestibular schwannomas: facial nerve function and hearing preservation. Neurosurgery 56:560–570

    Article  PubMed  Google Scholar 

  • Ebersold MJ, Harner SG, Beatty CW, Harper CM Jr, Quast LM (1992) Current results of the retrosigmoid approach to acoustic neurinoma. J Neurosurg 76:901–909

    Article  PubMed  CAS  Google Scholar 

  • Forton G, Moeneclaey L, Declau F, Marquet J (1989) The involvement of the cochlear nerve in neurinomas of the eighth cranial nerve. Arch Otorhinolaryngol 246:156–160

    Article  PubMed  CAS  Google Scholar 

  • Gharabaghi A, Samii A, Koerbel A, Rosahl SK, Tatagiba M, Samii M (2007) Preservation of function in vestibular schwannoma surgery. Neurosurgery 60:ONS124–ONS127

    Article  PubMed  Google Scholar 

  • Glasscock ME 3rd, Hays JW, Minor LB, Haynes DS, Carrasco VN (1993) Preservation of hearing in surgery for acoustic neuromas. J Neurosurg 78:864–870

    Article  PubMed  Google Scholar 

  • House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93:146–147

    PubMed  CAS  Google Scholar 

  • Jaaskelainen J, Paetau A, Pyykko I, Blomstedt G, Palva T, Troupp H (1994) Interface between the facial nerve and large acoustic neurinomas. Immunohistochemical study of the cleavage plane in NF2 and non-NF2 cases. J Neurosurg 80:541–547

    Article  PubMed  CAS  Google Scholar 

  • Kameda K, Shono T, Hashiguchi K, Yoshida F, Sasaki T (2010) Effect of tumor removal on tinnitus in patients with vestibular schwannoma. J Neurosurg 112:152–157

    Article  PubMed  Google Scholar 

  • Koos WT, Day JD, Matula C, Levy DI (1998) Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas. J Neurosurg 88:506–512

    Article  PubMed  CAS  Google Scholar 

  • Kuo TC, Jackler RK, Wong K, Blevins NH, Pitts LH (1997) Are acoustic neuromas encapsulated tumors? Otolaryngol Head Neck Surg 117:606–609

    Article  PubMed  CAS  Google Scholar 

  • Lescanne E, Velut S, Lefrancq T, Destrieux C (2002) The internal acoustic meatus and its meningeal layers: a microanatomical study. J Neurosurg 97:1191–1197

    Article  PubMed  Google Scholar 

  • Marquet JF, Forton GE, Offeciers FE, Moeneclaey LL (1990) The solitary schwannoma of the eighth cranial nerve. An immunohistochemical study of the cochlear nerve-tumor interface. Arch Otolaryngol Head Neck Surg 116:1023–1025

    Article  PubMed  CAS  Google Scholar 

  • Neely JG (1981) Gross and microscopic anatomy of the eighth cranial nerve in relationship to the solitary schwannoma. Laryngoscope 91:1512–1531

    Article  PubMed  CAS  Google Scholar 

  • Ojemann RG (2001) Retrosigmoid approach to acoustic neuroma (vestibular schwannoma). Neurosurgery 48:553–558

    Article  PubMed  CAS  Google Scholar 

  • Ojemann RG (2006) Suboccipital transmeatal approach to vestibular schwannoma. In: Schmidek HH, Roberts DW (eds) Operative neurosurgical technniques, vol 1. Elsevier, Philadelphia, pp 920–931

    Google Scholar 

  • Perre J, Viala P, Foncin JF (1990) Involvement of cochlear nerve in acoustic tumours. Acta Otolaryngol 110:245–252

    Article  PubMed  CAS  Google Scholar 

  • Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): hearing function in 1000 tumor resections. Neurosurgery 40:248–260

    Article  PubMed  CAS  Google Scholar 

  • Samii M, Gerganov V, Samii A (2006) Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients. J Neurosurg 105:527–535

    Article  PubMed  Google Scholar 

  • Sasaki T, Shono T, Hashiguchi K, Yoshida F, Suzuki SO (2009) Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery. J Neurosurg 110:648–655

    Article  PubMed  Google Scholar 

  • Wanibuchi M, Fukushima T, McElveen JT Jr, Friedman AH (2009) Hearing preservation in surgery for large vestibular schwannomas. J Neurosurg 111:845–854

    Article  PubMed  Google Scholar 

  • Watanabe K, Saito N, Taniguchi M, Kirino T, Sasaki T (2003) Analysis of taste disturbance before and after surgery in patients with vestibular schwannoma. J Neurosurg 99:999–1003

    Article  PubMed  Google Scholar 

  • Yasargil MG (1996) Microneurosurgery, vol IVB. Thieme, New York, pp 100–123

    Google Scholar 

  • Yasargil MG, Smith RD, Gasser JC (1977) Microsurgical approach to acoustic neurinomas. Adv Tech Stand Neurosurg 4:93–129

    Article  Google Scholar 

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Correspondence to Tomio Sasaki .

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Sasaki, T., Yoshimoto, K., Satoshi, S.O. (2012). Vestibular Schwannoma (VS) Surgery: Histological Considerations and Operative Results. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 7. Tumors of the Central Nervous System, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2894-3_35

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  • DOI: https://doi.org/10.1007/978-94-007-2894-3_35

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-2893-6

  • Online ISBN: 978-94-007-2894-3

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