Objective:

To evaluate the effectiveness of the subperineural resection technique in preserving neurological function and analyze postoperative outcomes in patients with intracranial schwannomas.

Approach:

• Patient Population: Retrospective analysis of 186 patients who underwent intracranial schwannoma resection from April 2011 to March 2022.
• Data Collection: Clinical and surgical data were collected, focusing on tumor characteristics, extent of resection, and postoperative symptoms.
• Surgical Methods: Standardized surgical techniques were employed by multiple neurosurgeons, utilizing subperineural dissection.
• Statistical Analysis: Statistical comparisons were made using appropriate tests, and regrowth-free survival was assessed using Kaplan–Meier curves.

Key Findings:

• Total resection rates for CN V (n=15), VII (n=4), VIII (n=148), IX–XI (n=12), and XII (n=3) schwannomas were 53.3%, 75%, 70.3%, 50%, and 0%, respectively.
• Regrowth occurred in 12/44 (27.3%) of CN VIII and 4/7 (57.1%) of CN V subtotal resection cases.
• Postoperative growth rates for CN VIII schwannomas were 0.22 mm/year and 126.3 mm³/year; for CN V, 0.7 mm/year and 23 mm³/year.
• Higher regrowth rates were observed in CN IX–XI (5/6, 83.3%) and CN XII (2/3, 66.7%) schwannomas.

Interpretation:

Subperineural resection is effective in preserving neurological function, but subtotal resection remains unavoidable in some cases, with varying regrowth rates based on cranial nerve origin.

Limitations:

• Retrospective design may introduce bias.
• Small sample sizes for certain cranial nerve schwannomas limit generalizability.

Conclusion:

Further large-scale analyses stratified by nerve origin are warranted.