• Atul Goel, Survendra Rai, Abhidha Shah, Neha Jadhav, Saswat Dandpat, Ravikiran Vutha, Akshay Hawaldar, and Nishchith Sudarshan.
• Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Mumbai, India; Department of Neurosurgery, Lilavati Hospital and Research Centre, Mumbai, India. Electronic address: atulgoel62@hotmail.com.
• World Neurosurg. 2020 Nov 1; 143: e261-e267.

ObjectiveWe describe the dural relationships and its surgical implications for large lower cranial nerve (CN) neurinomas. The study is based on surgical experience with 14 cases.MethodsDuring the period January 2014 to December 2019, 14 consecutive cases with large lower CN neurinomas were surgically treated with the aim of radical tumor resection.ResultsThere were 9 males and 5 females, ranging in age from 17 to 65 years. All patients were operated in a single stage. The principal surgical observation was that the entire extent of tumor, which included intracranial, jugular fossa, and extracranial components, was within the "dural" confines and the tumor adjoining critical neural and vascular structures was displaced around the dome of the tumor. Radical surgical resection was achieved in all cases. During the follow-up period that ranged from 3 to 71 months (average 32 months), no symptomatic recurrence was observed and no patient needed reoperation. At the time of last clinical follow-up, the lower CN function in all patients was better than at the time of presentation.ConclusionsThe "dural" cover of the lower CN neurinomas forms a strong and reliable plane of compartmentalization and allows safe tumor resection.Copyright © 2020 Elsevier Inc. All rights reserved.

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