ArticleFrontiers in oncology2026
A Single-center experience of subperineural resection of intracranial schwannomas and the clinical course following subtotal resection.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Subperineural resection technique is regarded as an effective surgical strategy for preserving neurological function in vestibular schwannomas (VSs); however, its application in non-vestibular schwannomas (NVSs) has been rarely reported. Furthermore, total resection (TR) cannot always be achieved, as dissection along the appropriate plane may be challenging, occasionally resulting in subtotal removal (STR). We have consistently employed the subperineural resection technique for all intracranial schwannomas. In this study, we aimed to evaluate its effectiveness in preserving neurological function and analyzed postoperative outcomes, with particular emphasis on the clinical course following subtotal resection (STR). Methods: 186 patients of intracranial schwannomas were retrospectively analyzed, focusing on the extent of resection and postoperative behavior of residual tumors. Tumor origin by cranial nerve (CN) was as follows: CN II (n=2), CN IV (n=1), CN V (n=15), CN VI (n=1), CN VII (n=4), CN VIII (n=148), CN IX-XI (n=12), and CN XII (n=3). Results: With subperineural resection, TR rates for CN V, VII, VIII, IX-XI, and XII schwannomas were 53.3%, 75%, 70.3%, 50%, and 0%, respectively. Among STR cases, regrowth occurred in 12/44 CN VIII (27.3%) and 4/7 CN V (57.1%), while retreatment was required in 4/44 and 0/7, respectively. For CN VIII schwannomas, postoperative planimetric and volumetric growth rates were 0.22 mm/year and 126.3 mm³/year; corresponding values for CN V were 0.7 mm/year and 23 mm³/year. In contrast, regrowth occurred in 5/6 CN IX-XI (83.3%) and 2/3CN XII (66.7%), with retreatment required in 2/6 CN IX-XI and 1/3 CN XII, indicating a relatively higher proportion despite the small sample size. Conclusion: Subperineural resection is an effective strategy, however, STR remains unavoidable in some cases. In CN VIII and CN V schwannomas, retreatment rates were low relative to regrowth. The optimal timing of postoperative radiotherapy following STR remains controversial, and further large-scale analyses stratified by the nerve of origin are warranted.
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