Surgical Outcomes of Jugular Foramen Tumors; Postoperative Facial Nerve Palsy and Lower Cranial Nerve Palsy / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Surgical treatment of jugular foramen tumors can have significant complications such as facial nerve palsy due to complicated regional anatomy. In this study, we investigated the outcomes and complications of surgical approach to the jugular foramen tumors. SUBJECTS AND METHOD: Thirteen patients had operations for their tumors around jugular foramen with a mean follow-up period of 52 months. We reviewed their medical records with emphasis on postoperative facial nerve palsy and other low cranial nerve palsies. RESULTS: There were jugular foramen schwannoma (n=9), glomus jugulare (n=2), meningioma (n=1) and chondrosarcoma (n=1). Gross total removal was achieved in 12 patients. Facial nerves were rerouted at genigulate ganglion (long rerouting) or at the second genu (short rerouting). Mastoidectomies were performed with canal wall-up (CWU) fashion or with canal wall-down (CWD) fashion. The mean size of tumor with long rerouting was significantly larger than that with short rerouting (p=0.037). Facial nerve palsy (FNP) greater than House-Brackmann grade (HB grade) III remained for more than 6 months in a patient. Low cranial nerve palsies were developed in 3 patients. CONCLUSION: Surgical treatment of jugular foramen tumors had a good local control rate with a low rate of complications. Depending on the size and location of tumors, detailed surgical methods can be determined to avoid unnecessary manipulation of facial nerve and loss of hearing.