{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:08:45Z","timestamp":1788419325067,"version":"build-2803163510"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The authors analyzed the tumor capsule and the tumor\u2013nerve interface in vestibular schwannomas (VSs) to define the ideal cleavage plane for maximal tumor removal with preservation of facial and cochlear nerve functions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Surgical specimens from 21 unilateral VSs were studied using classical H &amp; E, Masson trichrome, and immunohistochemical staining against myelin basic protein.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The authors observed a continuous thin connective tissue layer enveloping the surfaces of the tumors. Some nerve fibers, which were immunopositive to myelin basic protein and considered to be remnants of vestibular nerve fibers, were also identified widely beneath the connective tissue layer. These findings indicated that the socalled \u201ctumor capsule\u201d in VSs is the residual vestibular nerve tissue itself, consisting of the perineurium and underlying nerve fibers. There was no structure bordering the tumor parenchyma and the vestibular nerve fibers. In specimens of tumors removed en bloc with the cochlear nerves, the authors found that the connective tissue layer, corresponding to the perineurium of the cochlear nerve, clearly bordered the nerve fibers and tumor tissue.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Based on these histological observations, complete tumor resection can be achieved by removal of both tumor parenchyma and tumor capsule when a clear border between the tumor capsule and facial or cochlear nerve fibers can be identified intraoperatively. Conversely, when a severe adhesion between the tumor and facial or cochlear nerve fibers is observed, dissection of the vestibular nerve\u2013tumor interface (the subcapsular or subperineurial dissection) is recommended for preservation of the functions of these cranial nerves.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2008.4.17514","type":"journal-article","created":{"date-parts":[[2008,10,17]],"date-time":"2008-10-17T15:12:06Z","timestamp":1224256326000},"page":"648-655","source":"Crossref","is-referenced-by-count":41,"title":["Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery"],"prefix":"10.3171","volume":"110","author":[{"given":"Tomio","family":"Sasaki","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahisa","family":"Shono","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiaki","family":"Hashiguchi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi O.","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-17514","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1097\/01.PRS.0000160264.42201.F5","article-title":"Organization and microscopic anatomy of the adult human facial nerve: anatomical and histological basis for surgery","volume":"115","author":"Captier","year":"2005"},{"key":"b2-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"901","DOI":"10.3171\/jns.1992.76.6.0901","article-title":"Currents results of the retrosigmoid approach to acoustic neurinoma","volume":"76","author":"Ebersold","year":"1992"},{"key":"b3-17514","series-title":"Arch Otorhinolaryngol","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/BF00456658","article-title":"The involvement of the cochlear nerve in neurinomas of the eighth cranial nerve","volume":"246","author":"Forton","year":"1989"},{"key":"b4-17514","series-title":"Ann Otol Rhinol Laryngol","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1177\/000348948809700110","article-title":"Hearing preservation in unilateral acoustic neuroma surgery","volume":"97","author":"Gardner","year":"1988"},{"key":"b5-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"864","DOI":"10.3171\/jns.1993.78.6.0864","article-title":"Preservation of hearing in surgery for acoustic neuromas","volume":"78","author":"Glasscock","year":"1993"},{"key":"b6-17514","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S0090-3019(96)00487-9","article-title":"A comparative study of embedded nerve tissue in six NF2-associated schwannomas and 17 nonassociated NF2 schwannomas","volume":"48","author":"Hamada","year":"1997"},{"key":"b7-17514","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1177\/019459988509300202","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b8-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3171\/jns.1994.80.3.0541","article-title":"Interface between the facial nerve and large acoustic neurinomas","volume":"80","author":"J\u00e4\u00e4skel\u00e4inen","year":"1994"},{"key":"b9-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3171\/jns.1998.88.3.0506","article-title":"Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas","volume":"88","author":"Koos","year":"1998"},{"key":"b10-17514","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/S0194-5998(97)70040-8","article-title":"Are acoustic neuromas encapsulated tumors?","volume":"117","author":"Kuo","year":"1997"},{"key":"b11-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.3171\/jns.2002.97.5.1191","article-title":"The internal acoustic meatus and its meningeal layers: a microanatomical study","volume":"97","author":"Lescanne","year":"2002"},{"key":"b12-17514","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"422","DOI":"10.3171\/jns.1991.74.3.0422","article-title":"Radical intracapsular removal of acoustic neurinomas. 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