Clinical Outcomes Following Subperineural Resection of Intracranial Schwannomas

Overview

This study evaluates the effectiveness of subperineural resection in preserving neurological function in patients with intracranial schwannomas. It highlights the rates of total and subtotal resection, as well as the regrowth and retreatment rates associated with different cranial nerve origins.

Background

Intracranial schwannomas, particularly vestibular schwannomas, pose significant surgical challenges, especially in achieving total resection while preserving neurological function. The subperineural resection technique has been utilized to address these challenges, yet its application in non-vestibular schwannomas is less documented. Understanding the outcomes of this technique across different types of schwannomas is crucial for optimizing surgical strategies.

Data Highlights

Key Findings

• Subperineural resection achieved total resection rates of 53.3% for CN V schwannomas.
• For CN VIII schwannomas, the regrowth rate was 27.3% among subtotal resection cases.
• Retreatment was required in 9.1% of CN VIII cases and 0% of CN V cases.
• Higher regrowth rates were observed in CN IX–XI (83.3%) and CN XII (66.7%) schwannomas.
• Postoperative growth rates for CN VIII were 0.22 mm/year and for CN V were 0.7 mm/year.

Clinical Implications

The findings indicate variability in regrowth and retreatment rates based on the specific cranial nerve involved.

Conclusion

Subperineural resection presents challenges with subtotal resections. Further research is warranted to evaluate treatment protocols.

Related Resources & Content

1. Distribution and Features of Tumors Linked to Adverse Surgical Results in Individuals with Sporadic Spinal Schwannomas, 2025
2. Evaluation of Modern Quality Metrics in Vestibular Surgery, 2021
3. Approaches to Treating Peripheral and Intraspinal Schwannomas in Neurofibromatosis Type 2 and Schwannomatosis, 2022
4. Guidelines For The Treatment Of Adults With Vestibular Schwannoma, Congress of Neurological Surgeons, 2026
5. Determinants of Resection Extent and Neurological Outcomes in Transopercular Insular Glioma Surgery
6. 1. Guidelines For The Treatment Of Adults With Vestibular Schwannoma: Introduction And Methods Update - Congress of Neurological Surgeons (CNS)
7. CyberKnife Stereotactic Radiosurgery for Vestibular Schwannomas: Systematic Review and Meta-Analysis of Long-Term Tumor Control and Hearing Preservation Outcomes - PMC
8. Selective subperineurial dissection in vestibular schwannoma surgery: how I do it | Acta Neurochirurgica | Springer Nature Link