A Single-Institution Retrospective Study of Jugular Foramen Schwannoma Management

Radical Resection Versus Subtotal Intracranial Resection Through a Retrosigmoid Suboccipital Approach Followed by Radiosurgery

Eun Suk Park, Eun Jung Lee, Jun Bum Park, Young Hyun Cho, Seok Ho Hong, Jeong Hoon Kim, Chang Jin Kim

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)552-562
Number of pages11
JournalWorld Neurosurgery
Volume88
DOIs
StatePublished - 1 Apr 2016
Externally publishedYes

Fingerprint

Radiosurgery
Neurilemmoma
Neck
Retrospective Studies
Cranial Nerves
Deglutition Disorders
Skull Base
Postoperative Period
Databases
Morbidity
Recurrence
Therapeutics
Neoplasms

Keywords

  • Cranial nerve neoplasm
  • Glossopharyngeal nerve disease
  • Jugular foramen schwannomas
  • Neuroma
  • Surgery
  • Treatment outcome

Cite this

@article{7fbe2907a2fa4291833cacba246d19f1,
title = "A Single-Institution Retrospective Study of Jugular Foramen Schwannoma Management: Radical Resection Versus Subtotal Intracranial Resection Through a Retrosigmoid Suboccipital Approach Followed by Radiosurgery",
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.",
keywords = "Cranial nerve neoplasm, Glossopharyngeal nerve disease, Jugular foramen schwannomas, Neuroma, Surgery, Treatment outcome",
author = "Park, {Eun Suk} and Lee, {Eun Jung} and Park, {Jun Bum} and Cho, {Young Hyun} and Hong, {Seok Ho} and Kim, {Jeong Hoon} and Kim, {Chang Jin}",
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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. / Park, Eun Suk; Lee, Eun Jung; Park, Jun Bum; Cho, Young Hyun; Hong, Seok Ho; Kim, Jeong Hoon; Kim, Chang Jin.

In: World Neurosurgery, Vol. 88, 01.04.2016, p. 552-562.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A Single-Institution Retrospective Study of Jugular Foramen Schwannoma Management

T2 - Radical Resection Versus Subtotal Intracranial Resection Through a Retrosigmoid Suboccipital Approach Followed by Radiosurgery

AU - Park, Eun Suk

AU - Lee, Eun Jung

AU - Park, Jun Bum

AU - Cho, Young Hyun

AU - Hong, Seok Ho

AU - Kim, Jeong Hoon

AU - Kim, Chang Jin

PY - 2016/4/1

Y1 - 2016/4/1

N2 - 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.

AB - 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.

KW - Cranial nerve neoplasm

KW - Glossopharyngeal nerve disease

KW - Jugular foramen schwannomas

KW - Neuroma

KW - Surgery

KW - Treatment outcome

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U2 - 10.1016/j.wneu.2015.10.042

DO - 10.1016/j.wneu.2015.10.042

M3 - Article

VL - 88

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EP - 562

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JF - World Neurosurgery

SN - 1878-8750

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