{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T16:46:32Z","timestamp":1773506792255,"version":"3.50.1"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this study was to evaluate the clinical results and surgical outcomes of cystic vestibular schwannomas (VSs) with fluid-fluid levels.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Forty-five patients with cystic VSs and 86 with solid VSs were enrolled in the study. The patients in the cystic VSs were further divided into those with and without fluid-fluid levels. The clinical and neuroimaging features, intraoperative findings, and surgical outcomes of the 3 groups were retrospectively compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Peritumoral adhesion was significantly greater in the fluid-level group (70.8%) than in the nonfluid-level group (28.6%) and the solid group (25.6%; p &lt; 0.0001). Complete removal of the VS occurred significantly less in the fluid-level group (45.8%, 11\/24) than in the nonfluid-level group (76.2%, 16\/21) and the solid group (75.6%, 65\/86; p = 0.015). Postoperative facial nerve function in the fluid-level group was less favorable than in the other 2 groups; good\/satisfactory facial nerve function 1 year after surgery was noted in 50.0% cases in the fluid-level group compared with 83.3% cases in the nonfluid-level group (p = 0.038).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Cystic VSs with fluid-fluid levels more frequently adhered to surrounding neurovascular structures and had a less favorable surgical outcome. A possible mechanism of peritumoral adhesion is intratumoral hemorrhage and consequent inflammatory reactions that lead to destruction of the tumor-nerve barrier. These findings may be useful in predicting surgical outcome and planning surgical strategy preoperatively.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.6.jns121630","type":"journal-article","created":{"date-parts":[[2013,7,19]],"date-time":"2013-07-19T13:56:45Z","timestamp":1374242205000},"page":"197-206","source":"Crossref","is-referenced-by-count":22,"title":["Fluid-fluid level in cystic vestibular schwannoma: a predictor of peritumoral adhesion"],"prefix":"10.3171","volume":"120","author":[{"given":"Lei","family":"Xia","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunjiang","family":"Yu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingshan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ren","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanming","family":"Qu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoran","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingwang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianjiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueling","family":"Qi","sequence":"additional","affiliation":[{"name":"Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Yao","sequence":"additional","affiliation":[{"name":"Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns121630","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/BF00602603","article-title":"CT and MRI of haemorrhage into intracranial neuromas","volume":"35","author":"Asari","year":"1993"},{"key":"b2-jns121630","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s10143-005-0380-y","article-title":"Cystic versus solid vestibular schwannomas: a series of 80 grade III-IV patients","volume":"28","author":"Benech","year":"2005"},{"key":"b3-jns121630","series-title":"Acta Otolaryngol","doi-asserted-by":"publisher","first-page":"519","DOI":"10.3109\/00016489309135856","article-title":"Histology and neuro-imaging in cystic acoustic neuromas","volume":"113","author":"Charabi","year":"1993"},{"key":"b4-jns121630","series-title":"Laryngoscope","first-page":"1348","article-title":"Histopathology and growth pattern of cystic acoustic neuromas","volume":"104","author":"Charabi","year":"1994"},{"key":"b5-jns121630","series-title":"Arch Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1001\/archotol.1994.01880360031006","article-title":"Cystic acoustic neuromas. 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