Function-Preserving Multimodal Treatment for Jugular Foramen Meningiomas

Abstract

Objectives Despite being pathologically benign, jugular foramen meningioma (JFM) may be locally aggressive and spread in three compartments. Because of the complex anatomical location, radical removal of JFM usually causes serious morbidity through lower cranial nerve (LCN) deficits. To accomplish long-standing tumor control with good functional outcomes, we report function-preserving multimodal treatment (FMT) for JFM, comprising the combination of intradural tumor removal with the preservation of LCN function and stereotactic radiosurgery (RS) for the residual tumor. Materials This study investigated six JFM patients (five women, one man). Preoperatively, five patients showed no LCN sign. Results All patients underwent function-preserving retrosigmoid intradural tumor removal, and no patient developed new LCN deficit. Three patients underwent RS for the residual tumor at 8 to 12 months after surgery. After RS, all three tumors were controlled. No patients showed tumor recurrence or new LCN deficits in the follow-up period (2 months to 8 years). Conclusion FMT for JFMs can accomplish long-standing tumor control with excellent functional outcomes.

Surgical treatment of selected tumors via the navigated minimally invasive presigmoidal suprabulbar infralabyrinthine approach without rerouting of the facial nerve

“…With regard to the technical progress in radiosurgery, some have recommended subtotal resection with minimal dissection of neurovascular structures in the jugular foramen to improve neurological outcome followed by radiation therapy of the tumor remnants to decrease the rate of recurrence. [6,14,21,27,36] Radiation therapy, however, may result in tumor adherence to neurovascular structures around the jugular foramen making repeat surgeries more di cult. [44,49] Repeat surgeries, in general increase the risk of lower cranial nerve injuries due to scarring.…”

Surgical Management of Complex Skull Base Tumor Using Preoperative Multimodal Image Fusion Technology

“…[1][2][3][4] Surgical treatment of complex skull base tumors should be the first choice. [5][6][7] Tumor location, size, nature, and surrounding structures are significant to be evaluated comprehensively. Often it requires a preoperative multimodal image fusion and surgical approach simulation.…”

“…The total resection rate varies from 57% to 77% 1–4 . Surgical treatment of complex skull base tumors should be the first choice 5–7 . Tumor location, size, nature, and surrounding structures are significant to be evaluated comprehensively.…”