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Jugular Foramen Schwannomas: Diagnosis, Management, and Outcomes

Authors

  • Matthew A. Wilson BS,

    1. Department of Surgery, Division of Otolaryngology–-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
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  • Todd A. Hillman MD,

    Corresponding author
    1. Department of Surgery, Division of Otolaryngology–-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
    • Dr. Todd A. Hillman, University Medical Center Department of Surgery, Division of Otolaryngology–-Head and Neck Surgery 50 North Medical Drive, 3C120 Salt Lake City, UT 84132, U.S.A.
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  • Richard H. Wiggins MD,

    1. Department of Radiology, University of Utah, Salt Lake City, Utah, U.S.A.
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  • Clough Shelton MD

    1. Department of Surgery, Division of Otolaryngology–-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
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Abstract

Objectives/Hypothesis: To describe the presentation, radiographic findings, and surgical management of seven patients who have been diagnosed and treated with jugular foramen schwannomas at the University of Utah.

Study Design: Retrospective chart review.

Methods: The charts of seven patients diagnosed with jugular foramen schwannomas were reviewed for presentation symptoms, radiographic findings, and physical examination findings. For the six who underwent surgical excision, the surgical procedure used, cranial nerve function results, audiometric results, perioperative complications, and other follow-up data are presented.

Results: Seven patients were identified from ages 24 to 69 years. Six of the seven underwent surgical excision. Primary presentation symptoms included dizziness, hearing loss, dysphagia, diplopia, tongue paresis, and hoarseness. The choice of surgical approach was based on the size and location of the tumor. All patients had complete excision of their tumors. The nerve of origin included the glossopharyngeal, vagus, and spinal accessory nerves. Preoperative cranial nerve dysfunction continued postoperatively for lower cranial nerves but resolved in patients who were noted to have preoperative dysfunction of cranial nerve V and VI. The rate of new lower cranial nerve injury was 15% and was only seen in the cranial nerves that were determined to be the nerve of origin. In two cases, a temporary feeding tube was required. No recurrences have been noted to date.

Conclusions: Jugular foramen schwannomas can be successfully diagnosed preoperatively with computed tomography and magnetic resonance imaging. These tumors can be successfully managed with surgery and low morbidity.

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