Principles of Subperineurial Dissection Technique: A Potential Balance between Cranial Nerve Preservation and Extent of Resection in Koos Grade IV Vestibular Schwannomas

The healthy proximal segment of the inferior vestibular nerve was “partially” transected in a posterior-to-anterior direction, a few millimeters away from the tumor to land into the subperineurial dissection plane, which was subsequently advanced toward the interface between the tumor parenchyma and the surrounding residual nerve fibers. The established plane was advanced by a “three-hand technique” to repeat the dissection-resection steps in a medial-to-lateral direction toward the porus to protect the facial and cochlear nerves.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025