[Functional evaluation and management of lower cranial nerve injuring after jugular foramen tumor surgery].
OBJECTIVE
To evaluate the injuring and rehabilitation of lower cranial nerve after surgery of jugular foramen tumors.


METHODS
The lower cranial nerve functions were analyzed retrospectively in 32 cases with jugular foramen tumors in the past six years, including 12 jugular glomus, 10 schwannomas, three meningiomas, one cholesteatoma, two giant cell tumors, one fibromatosis, one chondromyxosarcoma, one adenoid cystic carcinoma and one embryonal rhabdomyosarcoma. All patients received surgical procedures. Total tumor removal was achieved in 30 cases, subtotal and partial resection were performed on one case respectively.


RESULTS
One case was died of intracranial bleeding after surgery, the other 31 were followed-up with a period from one to six years. Normal lower nerve functions were observed in five cases and new nerve deficits were observed in eight cases. Eighteen cases with poor nerve functions before surgery experienced additional nerve injuring manifestations. Eight cases received tracheotomy in perisurgical period, in which three were transient and five went home with tubes. Twenty cases were compensated well after a short period, and six cases failed to compensate. With a long-term follow-up for these six patients, three cases had well functional rehabilitation, two were partially compensated, and one was decompensated.


CONCLUSIONS
Lower cranial nerve dysfunction was the most common complication after jugular foramen tumor surgery. Preoperative nerve function evaluations, protection of nerve during surgery and early postoperative functional rehabilitation training were the key to better prognosis.
Wang
Zhaoyan
Z
Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital, Medical College of Shanghai Jiaotong University, Shanghai, 200092, China. wzyent@gmail.com
Wu
Hao
H
Huang
Qi
Q
Cao
Rongping
R
Chen
Xiangping
X
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D020209:Cranial Nerve Injuries / Q000209:etiology* / Q000517:prevention & control*; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D003391:Cranial Nerves / Q000473:pathology; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult