Conservative facial nerve management in jugular foramen schwannomas
| Autor: | Brackmann De, Cokkeser Y, Fayad Jn |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Hearing Loss Sensorineural Skull Neoplasms Neurosurgical Procedures Jugular Foramen Schwannoma Monitoring Intraoperative Medicine Cranial nerve disease Humans Aged Retrospective Studies Postoperative Care Surgical approach business.industry Petrous Apex Middle Aged Neuroma medicine.disease Facial nerve Cranial Nerve Diseases Surgery Facial Nerve medicine.anatomical_structure Otorhinolaryngology Middle ear Ataxia Female medicine.symptom Jugular Veins business Jugular foramen Neurilemmoma |
| Zdroj: | The American journal of otology. 21(2) |
| ISSN: | 0192-9763 |
| Popis: | Objective: Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving the jugular foramen, the objective was to show that a conservative approach to management of the facial nerve is sufficient with jugular foramen neuromas because of their noninfiltrative, less vascular nature and medial location in the jugular foramen. Study Design: Retrospective case review. Setting: Tertiary, private, multiphysician, otologic practice. Patients: Sixteen patients with jugular foramen schwannoma (18 procedures) treated between January 1975 and October 1995. The 8 male and 8 female patients ranged in age from 13 to 66 years (mean age 47.7 years). Intervention: One-stage, total jugular foramen neuroma removal without transposition of the facial nerve, using a variety of surgical approaches. Main Outcome Measures: Facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, complications. Results: One-stage total tumor removal was accomplished in all the cases. In 13 (72%) of the neuromas, removal was accomplished without facial nerve transposition. Transposition was performed in 2 revision cases in which scar tissue from a previous operation prevented complete control of the carotid artery and safe removal, 2 cases with large tumor extension anteriorly to the petrous apex, and 1 case with extensive involvement of the middle ear. A House-Brackmann facial nerve Grade I or II was obtained in 16 of the 18 procedures, with 1 Grade III and I case that remained Grade V, as it was preoperatively. Conclusions: One-stage, total tumor removal can be achieved with excellent control of the important vascular structures and without transposition of the facial nerve in a majority of jugular foramen schwannomas. |
| Databáze: | OpenAIRE |
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