A Hearing Preservation Technique for the Resection of Extensive Jugular Foramen Tumors
Article first published online: 2 JAN 2009
Copyright © 2001 The Triological Society
Volume 111, Issue 11, pages 2071–2076, November 2001
How to Cite
Kim, C. J., Yoo, S. J., Nam, S. Y. and Kim, S. Y. (2001), A Hearing Preservation Technique for the Resection of Extensive Jugular Foramen Tumors. The Laryngoscope, 111: 2071–2076. doi: 10.1097/00005537-200111000-00038
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 30 JUL 2001
- Jugular foramen;
- hearing preservation;
Objective To describe a modified surgical approach for patients who maintain hearing function with jugular foramen tumors that extend to the posterior cranial fossa and the neck.
Study Design A retrospective review of 6 patients with jugular foramen tumors that were resected by a combined suboccipital and infralabyrinthine–transcervicomastoid approach.
Methods A combined suboccipital and infralabyrinthine–transcervicomastoid approach is characterized as follows: 1) There is no ablation of ear structures except the infralabyrinthine mastoid bone; the auricle is retracted anteriorly while preserving the bony wall and skin of the ear canal. 2) After superficial parotidectomy, a limited length of nerve VII from the intratemporal vertical segment is rerouted to divisions of the parotid portion. 3) The tumor is removed along with the internal jugular vein and sigmoid sinus, then the extended intracranial mass is resected through an additional suboccipital approach.
Results Five of the 6 patients had complete removal of all gross tumors. There were no major complications or mortalities. The preoperative levels of hearing were preserved in 5 of the 6 patients. Favorable facial function in the immediate postoperative period was noted in 4 of the 6 patients. Incomplete paralysis of 2 patients recovered eventually.
Conclusion We propose that a combined suboccipital and infralabyrinthine–transcervicomastoid approach to the jugular foramen can provide sufficient exposure to resect most dumbbell-shaped tumors, and it could be the initial treatment of choice for patients with remnant hearing.