Jugular Foramen Tumors: Diagnosis and Treatment

Ramina, Ricardo; Maniglia, João J.; Neto, Maurício Coelho; Fernandes, Yvens Barbosa; Paschoal, Jorge Rizzato

doi:10.1055/s-2005-916577

Cited by 47 publications

(82 citation statements)

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“…Modern advances in skull base surgery techniques, interventional neuroradiology, neuroanaesthesia and intensive care unit (ICU) care [24] have significantly enhanced the chance of cure and good outcome of these patients. At the same time, the development of radiosurgical techniques has produced an additional tool that complements surgical resection.…”

Section: Introductionmentioning

confidence: 99%

Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases

et al. 2011

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Jugular foramen paragangliomas are rare skull base tumours posing multiple complex diagnostic and management problems. We did a study to evaluate surgical technique, outcome and complications in 75 cases of tumours treated by multidisciplinary approach (i.e. combined neurosurgery, neuroradiology, ear, nose and throat surgery and intensive care unit team). Retrospective study on 75 consecutive patients with jugular foramen paragangliomas treated surgically from 1989 to 2005. Preoperative balloon occlusion test was performed in all patients as well as embolization (100%). A combined limited infratemporal and juxtacondylar approach was used in all patients. Gross total resection was achieved in 59 patients (78.7%). The most common complication was represented by lower cranial nerve deficits in five patients (6.6%), which was only temporary in three. Postoperative facial nerve weakness occurred in five cases (6.6%) and resolved in three of them. The remaining two patients underwent facial nerve reconstruction by hypoglossal/facial nerve anastomosis. Four patients (5.3%) had a postoperative cerebrospinal fluid leak, which was successfully treated by lumbar drainage. Two patients (2.7%) died because of complications related to surgical injury of lower cranial nerves: one patient developed aspiration pneumonia and septicemia and the second one developed a large cervico-bulbar hematoma that led to severe respiratory distress and ultimately global cerebral hypoxia. Paragangliomas are rare and complex skull base lesions that may be managed with low morbidity and mortality if a multidisciplinary approach is considered. Facial and lower cranial nerve postoperative deficits can be limited.

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Section: Introductionmentioning

confidence: 99%

Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases

et al. 2011

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“…These require performing preoperative neuroimaging, audiometry and electrophysiological tests, and assessment of LCNs. They are informative for surgical plan, intraoperative monitoring, and postoperative management [18,19,45,63]. Because of hearing dysfunction, hoarse, or neck mass, normally patients with extracranial type of meningioma receive the treatment from otolaryngologist instead of neurosurgeons [3,5,36,50,51].…”

Section: Discussionmentioning

confidence: 99%

“…Removing temporal bone invaded by JFMs increased the risk of FN injury [3,7,10,34,46]. Intraoperative electrophysiological monitoring (IOEM) plays an important role for anatomical and function preservation in cranial nerves [18,19,45,46,63,70]. When tumor is fibrous, firm, and very difficult to peel off from the FN and LCNs, we would leave tiny parts of the tumor behind instead of radical aggressive resection.…”

Section: Surgical Approachesmentioning

confidence: 99%

Microsurgical management of primary jugular foramen meningiomas: a series of 22 cases and review of the literature

Tang

Zhang

et al. 2016

Neurosurg Rev

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This study summarized clinical manifestations, surgical management, histological grading, and long-term outcome of jugular foramen meningiomas (JFMs). Retrospective study was performed in 22 consecutive patients with primary JFMs from January 2004 to October 2010, enrolling 10 men and 12 women with average age of 39.4 (14-57 years). The most common initial symptom is hearing disorder, followed by lower cranial nerve dysfunctions. The tumor was classified into type I (intracranial) in 1, type II (intracranial) in 15, type IV (intracranial-extracranial) in 6, and none type III (extracranial). Surgical approaches mainly included retrosigmoid in 7, far lateral in 10, and juxtacondylar in 5, with some variations. The gross total resection was achieved in 15 cases and subtotal resection in 7. Fourteen patients (63.6 %) developed new or worse neurological deficits immediately after operation, of whom 11 (78.6 %) got alleviation. Postoperatively, keeping airway patency and prevention from aspiration pneumonia is very important. Nasotracheal intubation is much more tolerated than orotracheal intubation for postoperative patient management. WHO grade 2 was found in four cases (18.2 %) and grade 3 in one. During the average time of follow-up in 83.2 months, only one (grade 3) died of tumor regrowth 20 months after surgery and radiosurgery. Five of 17 patients of grade 1 developed tumor regrowth. Radiosurgery provides a good tumor control for tumor regrowth in grade 1, or postoperative grade 2 tumor. In conclusion, JFMs has a favorable long-term overall survival; however, neurological preservation is still challenging, especially low cranial nerves.

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“…L'immunohistochimie peut alors être utile pour démontrer la présence des cellules tumorales. Les paragangliomes tympaniques ou jugulotympaniques malins sont rares (moins de 5 % [59]). Le seul critère formel de malignité est l'existence d'une métastase ganglionnaire ou à distance (pulmonaire, osseuse, hépatique.…”

Section: Les Tumeurs De L'oreille Moyenneunclassified

Pathologie de l’oreille

Wassef

2009

Annales de Pathologie

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Jugular Foramen Tumors: Diagnosis and Treatment

Cited by 47 publications

References 0 publications

Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases

Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases

Microsurgical management of primary jugular foramen meningiomas: a series of 22 cases and review of the literature

Pathologie de l’oreille

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