title: Surgical treatment of jugular foramen schwannomas.
abstract: OBJECTIVE
  We present our experience with surgery of jugular foramen schwannomas with special consideration of clinical presentation, surgical technique, complications, and outcomes.
  
  
  METHODS
  This retrospective study includes ten patients with jugular foramen schwannomas treated by the senior author between January 2007 and December 2012. Three patients had undergone partial tumour resection elsewhere. The initial symptom for which they sought medical help was hearing loss, dysphagia, hoarseness, and shoulder weakness. Preoperative glossopharyngeal and vagal nerve deficits were the most common signs. In our series, tumour extension was classified according to Kaye-Pellet grading system. In two cases the tumours were classified into type A and 8 patients presented with type D tumours. A retromastoid suboccipital craniotomy was performed for type A tumours and modifications of cranio-cervical approach were suitable for type D.
  
  
  RESULTS
  No death occurred in this series. Four patients deteriorated after surgery: in two patients preoperative cranial nerve deficits deteriorated after surgery while new cranial nerve palsy occurred in 2 other patients. In four patients, the cranial nerve dysfunction had improved at the last follow-up examination. In all other patients, the cranial nerve dysfunction remained the same. One patient experienced tumour recurrence over a follow-up period of 40 months. This patient underwent a successful second surgery without further evidence of tumour growth.
  
  
  CONCLUSIONS
  Jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower CN deficits.
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland. Electronic address: arkady.n@wp.pl.
authors: Arkadiusz
authors: A
authors: Nowak
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Tomasz
authors: T
authors: Dziedzic
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Tomasz
authors: T
authors: Czernicki
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Przemysław
authors: P
authors: Kunert
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Andrzej
authors: A
authors: Marchel
mesh_terms: D000328:Adult; D003391:Cranial Nerves / Q000473:pathology; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005539:Foramen Magnum / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D059906:Neuroimaging; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Jugular foramen; Lower cranial nerve; Schwannoma; Skull base; Surgical approach