Long-Term Outcomes after Surgical Treatment of Jugular Foramen Schwannoma

ABSTRACT

The purpose of this article is to clarify long-term outcomes following surgery for jugular foramen schwannomas. Fifteen adult patients underwent surgery, predominantly via the lateral suboccipital approach, for jugular foramen schwannomas between December 1987 and May 2007. All information was collected retrospectively from patient medical records at a university hospital. The main outcome measures were tumor regrowth and IX-X nerve function at median 84.3 months (range, 12 to 166 months) following surgery. Near total removal was achieved in 10 patients, and the remaining 5 patients had subtotal removal. Tumor regrowth was observed in 9 of 15 patients at 6 to 89 months (mean, 31.2 months) after surgery. The actual tumor control rate was 70.0 ± 12.8% at 5 years. Fourteen of 15 patients exhibited IX-X nerve dysfunction immediately after surgery, but 8 of these 14 patients experienced amelioration of the symptoms at the final follow-up period. No patients required additional treatment. We found in our study that for jugular foramen schwannoma, tumor volume should be reduced as much as possible to avoid severe IX-X nerve damages postoperatively. If a small amount of tumor remains, long-term follow-up is necessary.

KEYWORDS

Jugular foramen schwannoma - lateral suboccipital approach - glossopharyngeal nerve - vagus nerve

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