Evidence map›Paper›PMID 42176026›Full record

ArticleActa neurochirurgica2026

Selective subperineurial dissection in vestibular schwannoma surgery: how I do it.

Taichi Sayanagi, Ryota Tamura, Takayuki Ohira, Masahiro Toda

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In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Taichi SayanagiDepartment of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Ryota TamuraDepartment of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. moltobello-r-610@keio.jp.
Takayuki OhiraDepartment of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Masahiro TodaDepartment of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe dissection plane in vestibular schwannoma surgery significantly influences facial and cochlear nerve outcomes. Although histological studies demonstrate that the "tumor capsule" represents vestibular nerve perineurium, epicapsular dissection along its outer surface remains prevalent in clinical practice.

methodWe describe subperineurial dissection, removing tumor from beneath the perineurium while preserving this protective layer on the facial and cochlear nerves. Key steps include early internal auditory canal drilling and identification of the true perineurial plane.

conclusionSubperineurial dissection prioritizes nerve function over radical resection, achieving high rates of facial nerve preservation with acceptable tumor control.

Indexed as

Cochlear NerveDissectionFacial NerveNeuroma, AcousticCraniotomyHumansCochlear nerveFacial nervePerineuriumSchwannomaSkull base surgery

Identifiers

PMID42176026
PMCPMC13381382

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.