title: Histologic findings in two very small intracanalicular solitary schwannomas of the eighth nerve: II. "Onion bulbs".
abstract: An "onion bulb" is a descriptive histologic term referring to concentric layers of Schwann cell processes about a myelinated nerve fiber. Between the layers of Schwann cells are increased amounts of longitudinally oriented collagen fibers. It is thought that onion bulbs form as a result of sequential segmental demyelination and remyelination attempts. This process can become so severe that the myelinated fiber loses its myelin and ultimately degenerates; however, many fibers remain viable and thinly myelinated. The physiologic effect of "onion bulbs" is to markedly decrease conduction velocity in the fiber affected. In the auditory system, incompletely myelinated cochlear nerve fibers in the infant and in patients with multiple sclerosis show delays of the auditory evoked potential latencies and psychoacoustic retrocochlear patterns. No anatomic substrate has been identified for these auditory tests patterns in the acoustic tumor (solitary schwannoma of the eighth nerve). Two very small intracanalicular acoustic tumors were resected en bloc with the nerve of origin, serially sectioned, stained for neural tissue, and studied by light microscopy. In both tumors, histologic findings consistent with onion bulb formation were discovered about some of the myelinated nerve fibers found deeply incorporated in the tumor mass. These findings suggest that demyelination, perhaps with the formation of onion bulbs, may be a histopathologic correlate for retrocochlear dysfunction seen in acoustic tumors.
authors.affiliation: Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City 73126.
authors.forename: J G
authors.initials: JG
authors.lastname: Neely
authors.forename: J V
authors.initials: JV
authors.lastname: Hough
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000473:pathology* / Q000601:surgery; D003711:Demyelinating Diseases / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery; D000159:Vestibulocochlear Nerve / Q000473:pathology* / Q000601:surgery