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The outermost “dura-like membrane” of vestibular schwannoma

BACKGROUND: The membranous structure of vestibular schwannoma is an important factor in its surgical treatment. Herein, we report intraoperative and microscopic findings relating to an outermost dura-like membrane in cases of vestibular schwannoma and the importance of these findings. METHODS: Intra...

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Autores principales: Tomio, Ryosuke, Yoshida, Kazunari, Kohno, Maya, Kamamoto, Dai, Mikami, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946263/
https://www.ncbi.nlm.nih.gov/pubmed/27453796
http://dx.doi.org/10.4103/2152-7806.185008
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author Tomio, Ryosuke
Yoshida, Kazunari
Kohno, Maya
Kamamoto, Dai
Mikami, Shuji
author_facet Tomio, Ryosuke
Yoshida, Kazunari
Kohno, Maya
Kamamoto, Dai
Mikami, Shuji
author_sort Tomio, Ryosuke
collection PubMed
description BACKGROUND: The membranous structure of vestibular schwannoma is an important factor in its surgical treatment. Herein, we report intraoperative and microscopic findings relating to an outermost dura-like membrane in cases of vestibular schwannoma and the importance of these findings. METHODS: Intraoperative findings of 16 cases of vestibular schwannoma treated with an initial surgery were studied with an aim to determine if the cases had a dura-like membrane. Then we studied microscopic findings of the dura-like membrane using hematoxylin and eosin, Masson trichrome, and immunohistochemical staining in 2 cases. RESULTS: The dura-like membrane was observed in 8 out of 16 cases. The average tumor size of the cases that had a dura-like membrane was 30 ± 8.1 mm, and Koos grading 4 was in 7 out of 8 cases, and one was grade 3. In cases without a dura-like membrane, these values were significantly smaller, with an average tumor size of 12.8 ± 5.2 mm, and Koos grading 4 was only in 1 of 8 cases, grade 3 was in 2 cases, and other 5 cases were grade 2. The outermost dura-like membrane enveloped the vestibular schwannoma around the internal acoustic meatus and was continuous with the dura mater. Reactive angiogenesis was observed in the dura mater. Microscopic findings proved its continuity with the dura mater. In one case, the facial nerve was damaged before it was identified during subcapsular dissection. In that case, the dura-like membrane negatively affected our ability to identify the facial nerve. CONCLUSIONS: A dura-like membrane sometimes envelops vestibular schwannoma around the internal acoustic meatus. Recognition of this membranous structure is important for the surgical preservation of facial and acoustic nerves.
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spelling pubmed-49462632016-07-22 The outermost “dura-like membrane” of vestibular schwannoma Tomio, Ryosuke Yoshida, Kazunari Kohno, Maya Kamamoto, Dai Mikami, Shuji Surg Neurol Int Original Article BACKGROUND: The membranous structure of vestibular schwannoma is an important factor in its surgical treatment. Herein, we report intraoperative and microscopic findings relating to an outermost dura-like membrane in cases of vestibular schwannoma and the importance of these findings. METHODS: Intraoperative findings of 16 cases of vestibular schwannoma treated with an initial surgery were studied with an aim to determine if the cases had a dura-like membrane. Then we studied microscopic findings of the dura-like membrane using hematoxylin and eosin, Masson trichrome, and immunohistochemical staining in 2 cases. RESULTS: The dura-like membrane was observed in 8 out of 16 cases. The average tumor size of the cases that had a dura-like membrane was 30 ± 8.1 mm, and Koos grading 4 was in 7 out of 8 cases, and one was grade 3. In cases without a dura-like membrane, these values were significantly smaller, with an average tumor size of 12.8 ± 5.2 mm, and Koos grading 4 was only in 1 of 8 cases, grade 3 was in 2 cases, and other 5 cases were grade 2. The outermost dura-like membrane enveloped the vestibular schwannoma around the internal acoustic meatus and was continuous with the dura mater. Reactive angiogenesis was observed in the dura mater. Microscopic findings proved its continuity with the dura mater. In one case, the facial nerve was damaged before it was identified during subcapsular dissection. In that case, the dura-like membrane negatively affected our ability to identify the facial nerve. CONCLUSIONS: A dura-like membrane sometimes envelops vestibular schwannoma around the internal acoustic meatus. Recognition of this membranous structure is important for the surgical preservation of facial and acoustic nerves. Medknow Publications & Media Pvt Ltd 2016-06-29 /pmc/articles/PMC4946263/ /pubmed/27453796 http://dx.doi.org/10.4103/2152-7806.185008 Text en Copyright: © Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Tomio, Ryosuke
Yoshida, Kazunari
Kohno, Maya
Kamamoto, Dai
Mikami, Shuji
The outermost “dura-like membrane” of vestibular schwannoma
title The outermost “dura-like membrane” of vestibular schwannoma
title_full The outermost “dura-like membrane” of vestibular schwannoma
title_fullStr The outermost “dura-like membrane” of vestibular schwannoma
title_full_unstemmed The outermost “dura-like membrane” of vestibular schwannoma
title_short The outermost “dura-like membrane” of vestibular schwannoma
title_sort outermost “dura-like membrane” of vestibular schwannoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946263/
https://www.ncbi.nlm.nih.gov/pubmed/27453796
http://dx.doi.org/10.4103/2152-7806.185008
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