Microsurgical Management of Jugular Foramen Schwannomas
Autor: | Cara L. Sedney, Takanori Fukushima, Ketan R. Bulsara, Yoichi Nonaka |
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Rok vydání: | 2013 |
Předmět: |
Adult
Male Reoperation Microsurgery medicine.medical_specialty Adolescent Cerebrospinal Fluid Rhinorrhea medicine.medical_treatment Tumor resection Neurosurgical Procedures Resection Cohort Studies Young Adult medicine Humans Cranial Nerve Neoplasms Child Hearing Loss Nerve preservation Aged Retrospective Studies Cranial nerve deficits Cerebrospinal Fluid Leak business.industry Cranial nerves Middle Aged Gross Total Resection Surgery Treatment Outcome medicine.anatomical_structure Case-Control Studies Female Neurology (clinical) business Neurilemmoma Jugular foramen Follow-Up Studies |
Zdroj: | Neurosurgery. 72:42-46 |
ISSN: | 0148-396X |
Popis: | 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. |
Databáze: | OpenAIRE |
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