Jugular Foramen Schwannomas: Surgical Approaches and Outcome of Treatment

Micro-neurosurgical excision of dumbbell shaped very large jugular foramen schwannoma

“…A study 38 reporting on a series of 16 JF schwannomas of whom five were type IE described that in the immediate post-operative period, a temporary cranial nerve morbidity rate was 38% three patients experiencing facial palsy, one abducent palsy, one swallowing problems and one tongue weakness as new deficits; in the other patients, the cranial nerve dysfunction remained as it was pre-operatively and with a mean follow-up of 22 months, all cranial nerve dysfunction improved considerably. Another series 45 reported a total resection in six of 12 patients, a near total in three and a subtotal in three with a tumor progression in two of the three patients having sub-total excision. In one patient, a tumor re-growth was recorded 12 months after surgery and had radiosurgery; in another re-growth, it occurred within 8 months and a malignant peripheral nerve sheath tumour was identified.…”

The Jugular Foramen Schwannomas: Review of the Large Surgical Series

“…Some of the patients present headache, blurred vision or nystagmus because of increased intracranial pressure. Kaye et al 9) reported that presenting symptoms varied according to the growth pattern of tumors; but Yoo et al 24) had not found statistical correlation between tumor type and clinical presentation. Syndromes associated with space-occupying lesions around the JF are described as follows : Vernet's syndrome; Collet-Sicard's syndrome; Villaret's syndrome; Avellis' syndrome; Jackson's syndrome 21) .…”

“…Another common MR scans abnormal images of the JF is a pseudomass. Turbulent venous flow within the JF may mimic a schwannoma at this region and cause to misdiagnosis 23,24) .…”

“…Radiologically, the differential diagnosis of these tumors include jugular paragangliomas, vestibular schwannomas and other cranial nerve sheath tumors, meningiomas, hypoglossal neurinomas, metastatic tumors, ependymomas, other tumors involving of the cerebellopontine angle (namely meningiomas, choroid plexus papillomas, chordomas, exophytic pontine gliomas, chondromas, cerebellar hemangioblastomas, myxofibrosarcomas, epidermoid cysts, carcinomas of the tympanic cavity, lymphomas, salivary glands tumors, squamous cell carcinoma), infectious lesions (from middle ear cavity, mastoid air cells or external auditory canal) and pseudomasses such as normal vascular asymmetry, a high jugular bulb or jugular diverticulum and aneurysms of the petrous part of carotid artery 1,17,18,24) . Thin slice CT scans provide adequate data about the enlargement of the jugular canal.…”

“…Jugular foramen schwannomas commonly occur between third and sixth decades of life, mainly in women and there seems to be no tumor predilection for the left or right side 17,24) . Sex and age discriminations of this study were as follows: 98 of 181 patients were women, and except of one article their mean of age was 40.4 years (minimum 13 maximum 73 years).…”