Schwannomas of the Jugular Foramen.

Kim, Tae Sun; Jung, Shin; Kang, Sam Suk; Lee, Jung Kil; Kim, Jae Hyoo; Kim, Soo Han; Lee, Je Hyuk

Case Report

Journal of Korean Neurosurgical Society 1998;27(4): 488-495.

Tae Sun Kim, Shin Jung, Sam Suk Kang, Jung Kil Lee, Jae Hyoo Kim, Soo Han Kim, Je Hyuk Lee

¹Department of NeurosurgeryKorea Chonnam University Hospital, Kwangju, Korea.
²Chonnam National University Research Institute of Medical Sciences, Kwangju, Korea.

ABSTRACT

We describe four cases of schwannoma of the jugular foramen in which surgery was performed in the Department of Neurosurgery, Chonnam University Hosipital. Three patients were men and one was a woman, and their mean age was 42.5 years. Patients with neurofibromatosis were excluded from our study and the records of the four patients were retrospectively reviewed with regard to clinical features, diagnosis, and management. The initial symptom were hoarseness, headache and tinnitus. Computed tomography, magnetic resonance imaging and cerebral angiography were found to provide the best preoperative localization and differential diagnosis of these lesions, and allowed better planning of the surgical approach. In three cases the tumor was dumbbell-shaped, with both an intraand extracranial component; surgery involved a combination of the lateral suboccipital infralabyrinthine and neurosurgical-otological approach. The other tumor was located primarily at the cerebellopontine angle with minimal enlargement of the jugular foramen; surgical resection involved a retrosigmoid suboccipital craniectomy. The aim of surgery was total excision of the tumor, and this was achieved in all cases. There was no operative mortality or major morbidity. Postoperative complication were lower cranial nerve deficit, including swallowing difficulty, hoarseness and transient facial nerve palsy and aspiration pneumonia, though improvement was noted within a few months. In all cases, the outcome was good; the follow-up period ranged from 6 to 30(mean 15) months and MRI imaging showed no tumor recurrence.

Key Words: Jugular foramen; Schwannoma; Retrosigmoid craniectomy