open access

Vol 48, No 3 (2014)
Original research articles
Submitted: 2014-02-23
Get Citation

Surgical treatment of jugular foramen schwannomas

Arkadiusz Nowak, Tomasz Dziedzic, Tomasz Czernicki, Przemysław Kunert, Andrzej Marchel
DOI: 10.1016/j.pjnns.2014.05.004
·
Neurol Neurochir Pol 2014;48(3):188-195.

open access

Vol 48, No 3 (2014)
Original research articles
Submitted: 2014-02-23

Abstract

Objective

We present our experience with surgery of jugular foramen schwannomas with special consideration of clinical presentation, surgical technique, complications, and outcomes.

Methods

This retrospective study includes ten patients with jugular foramen schwannomas treated by the senior author between January 2007 and December 2012. Three patients had undergone partial tumour resection elsewhere. The initial symptom for which they sought medical help was hearing loss, dysphagia, hoarseness, and shoulder weakness. Preoperative glossopharyngeal and vagal nerve deficits were the most common signs. In our series, tumour extension was classified according to Kaye-Pellet grading system. In two cases the tumours were classified into type A and 8 patients presented with type D tumours. A retromastoid suboccipital craniotomy was performed for type A tumours and modifications of cranio-cervical approach were suitable for type D.

Results

No death occurred in this series. Four patients deteriorated after surgery: in two patients preoperative cranial nerve deficits deteriorated after surgery while new cranial nerve palsy occurred in 2 other patients. In four patients, the cranial nerve dysfunction had improved at the last follow-up examination. In all other patients, the cranial nerve dysfunction remained the same. One patient experienced tumour recurrence over a follow-up period of 40 months. This patient underwent a successful second surgery without further evidence of tumour growth.

Conclusions

Jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower CN deficits.

Abstract

Objective

We present our experience with surgery of jugular foramen schwannomas with special consideration of clinical presentation, surgical technique, complications, and outcomes.

Methods

This retrospective study includes ten patients with jugular foramen schwannomas treated by the senior author between January 2007 and December 2012. Three patients had undergone partial tumour resection elsewhere. The initial symptom for which they sought medical help was hearing loss, dysphagia, hoarseness, and shoulder weakness. Preoperative glossopharyngeal and vagal nerve deficits were the most common signs. In our series, tumour extension was classified according to Kaye-Pellet grading system. In two cases the tumours were classified into type A and 8 patients presented with type D tumours. A retromastoid suboccipital craniotomy was performed for type A tumours and modifications of cranio-cervical approach were suitable for type D.

Results

No death occurred in this series. Four patients deteriorated after surgery: in two patients preoperative cranial nerve deficits deteriorated after surgery while new cranial nerve palsy occurred in 2 other patients. In four patients, the cranial nerve dysfunction had improved at the last follow-up examination. In all other patients, the cranial nerve dysfunction remained the same. One patient experienced tumour recurrence over a follow-up period of 40 months. This patient underwent a successful second surgery without further evidence of tumour growth.

Conclusions

Jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower CN deficits.

Get Citation

Keywords

Schwannoma, Jugular foramen, Lower cranial nerve, Skull base, Surgical approach

About this article
Title

Surgical treatment of jugular foramen schwannomas

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 48, No 3 (2014)

Pages

188-195

DOI

10.1016/j.pjnns.2014.05.004

Bibliographic record

Neurol Neurochir Pol 2014;48(3):188-195.

Keywords

Schwannoma
Jugular foramen
Lower cranial nerve
Skull base
Surgical approach

Authors

Arkadiusz Nowak
Tomasz Dziedzic
Tomasz Czernicki
Przemysław Kunert
Andrzej Marchel

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