Neurinoma of the jugular foramen

Müller‐Forell, Wibke; Dei-Anang, Kwesi; Perneczky, Axel; Mann, W.

doi:10.1007/bf00589122

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…Our modified classification scheme facilitated improved preoperative planning. The evolution of surgical treatment of jugular foramen schwannomas has been slow 1,4,6,7,[10][11][12]16,19,[21][22][23][26][27][28][29]31,32,36,37,42,43,45,[48][49][50][51][52][53]56,57,60,62,64,[67][68][69][70][71][72]76,77,79 (Table 3). This is primarily due to the rarity of the lesion and the complexity of the critical neurovascular anatomy associated with these lesions.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical management of 53 jugular foramen schwannomas: lessons learned incorporated into a modified grading system

Bulsara

Sameshima²,

Friedman

et al. 2008

JNS

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A dvAnces in microsurgical techniques and cranial base approaches have allowed access to areas of the brain once considered inaccessible. Despite these advances, however, the microsurgical resection of jugular foramen schwannomas continues to pose a formidable challenge. Fewer than 200 cases of schwannomas arising from the jugular foramen have been reported in the literature, a testament to the rarity of this tumor. 25,29,41,53,59,65,71,74 Experience has shown that the traditional suboccipital and transmastoid approaches do not provide adequate exposure of these lesions. Understanding and utilizing advanced skull base surgery techniques and concepts is essential for adequate resection of these tumors with CN preservation. We review the senior author's experience (T.F.) in the management of 53 jugular foramen schwannomas and propose a modified grading scheme to guide operative planning for these tumors. MethodsWe retrospectively reviewed all cases of jugular foramen schwannomas treated by the senior author Object. Due to the proximity and involvement of critical neurovascular structures, the resection of jugular foramen schwannomas can pose a formidable challenge. The authors review their experience in the microsurgical management of jugular foramen schwannomas and propose a modified grading scale to guide surgical management.Methods. All jugular foramen schwannoma cases treated by the senior author (T.F.) between 1980 and 2004 were retrospectively reviewed. The average age at presentation, surgical approach, tumor characteristics, cranial nerve (CN) deficits, and tumor recurrence rates were assessed. The authors present the following modified grading scale: Type A, intradural tumors; Type B, dumbbell-shaped tumors; and Type C, triple dumbbell tumors with a high cervical extension.Results. The authors treated jugular foramen tumors in 129 patients during the study period. Of these, 53 patients (41%) had jugular foramen schwannomas. The mean patient age was 52 years (range 14-74 years); there were 12 male and 41 female patients. The mean follow-up period was 8.4 years. Patients presented most commonly with deficits of the vagus nerve, followed by vestibular/cochlear nerve and glossopharyngeal nerve deficits. Gross-total resection of the tumor was achieved in 48 patients (90.5%). New postoperative paresis in a previously normal CN was not seen; however, worsening of preoperative CN deficits was frequently noted. The highest incidence occurred with the glossopharyngeal and vagus nerves (30%), with 26% of the deficits being permanent. There were no deaths related to surgery in this series. Three patients (5.7%) experienced tumor recurrence.Conclusions. The microsurgical resection of jugular foramen schwannomas carries a risk of worsening preoperative CN deficits; however, these are often transient. Based on their experience, the authors have formulated a grading scale that predicts the optimal surgical approach to these lesions. Considerable technical training and microneuroanatomical knowledge of the region is requi...

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Section: Discussionmentioning

confidence: 99%

Microsurgical management of 53 jugular foramen schwannomas: lessons learned incorporated into a modified grading system

Bulsara

Sameshima²,

Friedman

et al. 2008

JNS

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“…If the tumor is of considerable size, a fourth ventricular displacement is seen. 32 MRI and MR angiography have revolutionized the diagnosis of these tumors. The soft-tissue details, vascular supply, relationship with major vessels, as well as the patency of the jugular bulb are well appreciated on MRI with gadolinium enhancement and MR angiography.…”

Section: A _ Bmentioning

confidence: 99%

“…Enhancement is considerably greater in meningiomas, whereas signal-void areas, indicating vascularity, are more prominent in glomus jugular tumors. 29,30,32,62 Conventional angiography cannot always be dispensed, because MR angiography is not yet fully developed. Occasional tumors of the jugular foramen have been described as being moderately vascularized,2' but not as much as the highly vascular glomus jugular tumors.…”

Section: A _ Bmentioning

confidence: 99%

Glossopharyngeal Nerve Schwannoma: Report of a Case Operated on by the Far-Lateral Transcondylar Approach

Puzzilli¹,

Mastronardi²,

Agrillo³

et al. 1999

Skull Base

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Complete resection with conservation of cranial nerves is the primary goal of contemporary surgery for lower cranial nerve tumors. We describe the case of a patient with a schwannoma of the left glossopharyngeal nerve, operated on in our Neurosurgical Unit. The far lateral approach combined with laminectomy of the posterior arch of C1 was done in two steps. The procedure allowed total tumor resection and was found to be better than classic unilateral suboccipital or combined supra- and infratentorial approaches. The advantages and disadvantages of the far lateral transcondylar approach, compared to the other more common approaches, are discussed.

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Primarily Extracranial Jugular Foramen Neurinoma Manifesting with Marked Hemiatrophy of the Tongue: Case Report

Kanemoto¹,

Ochiai²,

Yoshimoto³

et al. 1998

Surgical Neurology

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Neurinoma of the jugular foramen

Cited by 8 publications

References 6 publications

Microsurgical management of 53 jugular foramen schwannomas: lessons learned incorporated into a modified grading system

Microsurgical management of 53 jugular foramen schwannomas: lessons learned incorporated into a modified grading system

Glossopharyngeal Nerve Schwannoma: Report of a Case Operated on by the Far-Lateral Transcondylar Approach

Primarily Extracranial Jugular Foramen Neurinoma Manifesting with Marked Hemiatrophy of the Tongue: Case Report

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