BACKGROUND: Jugular foramen schwannomas are uncommon and surgically challenging lesions. OBJECTIVE: To determine the importance of surgical technique on morbidity and recurrence of jugular foramen schwannomas. METHODS: A retrospective review and case-control analysis of a single-senior-surgeon series of 81 patients with surgically treated jugular foramen schwannomas was performed, focusing on operative technique. Patients undergoing an aggressive, total tumor resection (series 1) were compared with those undergoing more conservative resection focusing on preserving the pars nervosa (series 2). RESULTS: There was a statistically significant (P = .04) decrease in permanent deficits of the cranial nerve 9/10 complex with a conservative technique. Recurrence was seen in 3 patients (5.7%) in series 1 and in 3 patients (10.7%) in series 2 (P = .36). Recurrence was treated with reoperation in 1 patient, radiation in 1 patient, and observation in the others. CONCLUSION: Although radical gross total resection is desirable, it is not optimal for cranial nerve preservation in patients with jugular foramen schwannomas. A more conservative approach resulted in a statistically significant decrease in lower cranial nerve deficits. There was a nonstatistically significant trend toward increasing recurrence, which may be treated with multiple modality therapy in the modern era.
BACKGROUND:Jugular foramen schwannomas are uncommon and surgically challenging lesions. OBJECTIVE: To determine the importance of surgical technique on morbidity and recurrence of jugular foramen schwannomas. METHODS: A retrospective review and case-control analysis of a single-senior-surgeon series of 81 patients with surgically treated jugular foramen schwannomas was performed, focusing on operative technique. Patients undergoing an aggressive, total tumor resection (series 1) were compared with those undergoing more conservative resection focusing on preserving the pars nervosa (series 2). RESULTS: There was a statistically significant (P = .04) decrease in permanent deficits of the cranial nerve 9/10 complex with a conservative technique. Recurrence was seen in 3 patients (5.7%) in series 1 and in 3 patients (10.7%) in series 2 (P = .36). Recurrence was treated with reoperation in 1 patient, radiation in 1 patient, and observation in the others. CONCLUSION: Although radical gross total resection is desirable, it is not optimal for cranial nerve preservation in patients with jugular foramen schwannomas. A more conservative approach resulted in a statistically significant decrease in lower cranial nerve deficits. There was a nonstatistically significant trend toward increasing recurrence, which may be treated with multiple modality therapy in the modern era.
Authors: Jarnail Bal; Michael Bruneau; Moncef Berhouma; Jan F Cornelius; Luigi M Cavallo; Roy T Daniel; Sebastien Froelich; Emmanuel Jouanneau; Torstein R Meling; Mahmoud Messerer; Pierre-Hugues Roche; Henry Schroeder; Marcos Tatagiba; Idoya Zazpe; Dimitrios Paraskevopoulos Journal: Acta Neurochir (Wien) Date: 2021-12-02 Impact factor: 2.216
Authors: Carlos Suárez; Fernando López; William M Mendenhall; Simon Andreasen; Lauge Hjorth Mikkelsen; Johannes A Langendijk; Stefano Bondi; Juan P Rodrigo; Leif Bäck; Antti A Mäkitie; Verónica Fernández-Alvarez; Andrés Coca-Pelaz; Robert Smee; Alessandra Rinaldo; Alfio Ferlito Journal: Cancer Manag Res Date: 2021-01-18 Impact factor: 3.989
Authors: Young Goo Kim; Chang Kyu Park; Na Young Jung; Hyun Ho Jung; Jong Hee Chang; Jin Woo Chang; Won Seok Chang Journal: Radiat Oncol Date: 2022-05-07 Impact factor: 4.309