Surgical rehabilitation of voice and swallowing after jugular foramen surgery.
OBJECTIVE
We sought to determine the patient population that will benefit from surgical rehabilitation of voice and swallowing after jugular foramen tumor (JFT) resection.


METHODS
We performed a retrospective case study of patients with a history of JFT resection. The patients' files were reviewed for data on preoperative and postoperative function of cranial nerves VII and IX through XII, voice and swallowing function, and surgical procedures for voice and swallowing rehabilitation and their timing.


RESULTS
Twenty-one patients underwent JFT resection. Thirty-eight percent presented with deficits of cranial nerves VII and IX through XII, and 61% developed new postoperative deficits. Three patients recovered glossopharyngeal nerve function, 2 recovered vagus nerve function, and 1 recovered facial nerve function. Surgical rehabilitation procedures were undertaken in 8 patients. Patients who eventually underwent surgical rehabilitation procedures for voice and swallowing tended to have larger tumors, tumors within the nerve bundle in the jugular foramen, and multiple nerve deficits.


CONCLUSIONS
Most patients with multiple deficits of cranial nerves VII and IX through XII after JFT resection are unlikely to regain spontaneous nerve function, will experience long-term dysphonia and dysphagia, and will elect to undergo corrective surgery to improve voice and swallowing. Preoperative evaluation and close postoperative follow-up can identify patients who would benefit from early surgical rehabilitation.
Oestreicher-Kedem
Yael
Y
Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California, USA.
Agrawal
Sumit
S
Jackler
Robert K
RK
Damrose
Edward J
EJ
D000293:Adolescent; D000328:Adult; D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000601:surgery*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005925:Glomus Jugulare Tumor / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D055815:Young Adult