This is an interesting retrospective study evaluating peritumoral oedema on magnetic resonance images and correlating it with the intra-operative tumour characteristics and outcome. The study results found that vestibular schwannomas with peritumoral oedema were associated with greater incidence of hypervascularity and so had a higher incidence of postoperative tumour bed haemorrhages. The presence of peritumoral oedema however did not correlate to the degree of tumour adhesion and was not associated with more radical tumour removal. The long-term outcome of facial nerve function and hearing was similar in vestibular schwannoma patients with and without peritumoral oedema. The authors report that despite the increased vascularity, the surgical resection and dissecting the arachnoid plane was not more difficult. However, this aberration may be due to the fact that the senior author is very experienced! Surgeons with less experience are likely to find the resection of vestibular schwannomas with peritumoral oedema more challenging. 

Prognostic significance of peritumoral edema in patients with vestibular schwannomas.
Samii M, Giordano M, Metwali H, Almarzooq O, Samii A, Gerganov VN.
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Gauri Mankekar

Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.

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