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A Single-Institution Retrospective Study of Jugular Foramen Schwannoma Management: Radical Resection Versus Subtotal Intracranial Resection Through a Retrosigmoid Suboccipital Approach Followed by Radiosurgery
- Source :
- World Neurosurgery. 88:552-562
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background Despite advances in skull base surgery, achieving effective surgical management of jugular foramen schwannomas (JFSs) that avoids postoperative cranial nerve (CN) deficits remains a challenge. Subtotal resection followed by radiosurgery (rather than radical resection) is increasingly being viewed as a better treatment strategy. Here, an institutional database was retrospectively analyzed for outcomes after surgical treatment of JFSs to evaluate the optimal strategy for managing JFSs. Methods Twenty-two patients with JFSs were operated on by either radical resection ( n = 13) or conservative resection plus radiosurgery ( n = 9). These 2 different groups were compared in terms of early (≤4 weeks after surgery) and late postoperative functional outcome and oncologic control. Results No deaths occurred in either group, but there were 3 surgery-related complications in the radical resection group. Postoperative CN deficits and additional procedures related to CN morbidity were generally higher in the radical resection group, but the differences were not statistically significant. The conservative surgery group showed a statistically significant improvement in the level of dysphagia and dysphagia-related functional state in the late postoperative period. There was 1 case of recurrence after radical resection over a mean follow-up period of 73 months. All tumors in the conservative surgery group were controlled over a mean period of 34 months. Conclusions Our results suggest that conservative resection of JFSs via a familiar intracranial approach plus radiosurgery may be an effective surgical alternative for improving functional outcome with adequate oncologic control.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Radiosurgery
Skull Base Neoplasms
Young Adult
03 medical and health sciences
0302 clinical medicine
Jugular Foramen Schwannoma
medicine
Humans
Minimally Invasive Surgical Procedures
Cranial Nerve Neoplasms
Aged
Retrospective Studies
medicine.diagnostic_test
Brain Neoplasms
business.industry
Magnetic resonance imaging
Retrospective cohort study
Middle Aged
Neuroma
medicine.disease
Dysphagia
Surgery
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Occipital Lobe
Neurology (clinical)
medicine.symptom
business
Neurilemmoma
030217 neurology & neurosurgery
Jugular foramen
Cranial Nerve Neoplasm
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 88
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....4e035f4001fcd9be2f198c9ae0312595