title: Triple dumbbell-shaped jugular foramen schwannomas.
abstract: OBJECTIVE
  Triple dumbbell-shaped jugular foremen schwannomas (DSJFSs) have high cervical extension according to Bulsara's classification. One-stage, single-discipline, total removal of triple DSJFSs is not always possible due to their both intracranial and cervical extensions. We evaluated our experience in one-stage resection of triple DSJFSs by using a combined neurosurgical and head and neck approach.
  
  
  METHODS
  Between October 2004 and May 2009, eight patients with triple DSJFSs were treated surgically at our institute. The clinical and radiological features, operative procedures and outcomes are retrospectively reviewed.
  
  
  RESULTS
  Total tumour removal was achieved in seven patients and near total in one. New cranial nerve (CN) paresis occurred after surgery in one patient and worsening of preoperative CN deficits was noted in three. Two patients experienced cerebrospinal fluid leakage and one of them had a repeated operation with closure of the dural deficit. Follow-up period ranged from 23 to 60 months (mean 38 months). All CN dysfunction had improved considerably at the last follow-up examination. There have been no clinical or radiological signs of tumour recurrence.
  
  
  CONCLUSIONS
  One-stage total resection of triple DSJFSs can be achieved by a multidisciplinary cranial base team composed of neurosurgeons and head and neck surgeons via a craniocervical approach.
authors: Department of Neurosurgery, Chinese Academy of Medical Sciences, Beijing, China.
authors: Jing-Hai
authors: JH
authors: Wan
authors: Yue-Huang
authors: YH
authors: Wu
authors: Zheng-Jiang
authors: ZJ
authors: Li
authors: Xue-Ji
authors: XJ
authors: Li
authors: Hai-Peng
authors: HP
authors: Qian
authors: Xiao-Li
authors: XL
authors: Meng
authors: Zhen-Gang
authors: ZG
authors: Xu
mesh_terms: D000328:Adult; D003388:Cranial Fossa, Posterior / Q000601:surgery; D003389:Cranial Nerve Diseases / Q000209:etiology; D003390:Cranial Nerve Neoplasms / Q000145:classification / Q000601:surgery*; D003392:Cranial Sinuses / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D004388:Dura Mater / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D060787:Neoplasm Grading; D009442:Neurilemmoma / Q000145:classification / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D010243:Paralysis / Q000209:etiology; D010348:Patient Care Team; D011183:Postoperative Complications; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000145:classification / Q000601:surgery*; D013353:Subdural Effusion / Q000209:etiology; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome