[Jugular Foramen Schwannoma].

Abstract

Jugular foramen schwannoma is a rare intracranial tumor, with few opportunities for surgeons to perform tumor excision. This study aimed to provide an outline of jugular foramen schwannoma and our surgical strategy for this tumor. The surgical approach depends on tumor growth patterns with or without extracranial extension. In our institute, a lateral suboccipital retrosigmoid approach is used for intracranial tumors, and mastoidectomy is added for extracranial tumors. For accuracy and safety, neuronavigation and intraoperative neurological monitoring are applied to assist surgery. Herein details of surgical procedures are described. Because functional preservation is prioritized in surgery, intracapsular removal is recommended to prevent adhering cranial nerves from being injured by direct manipulation. Stereotactic radiosurgery has also shown good tumor control. Therefore, the goal of treatment is to achieve good tumor control without deterioration of neurological status during a patient's lifetime using both microsurgery and stereotactic radiosurgery. When considering patient-specific factors such as age and tumor size, less invasive skull base surgery is still necessary to treat jugular foramen schwannoma, for which neurosurgeons require knowledge of the anatomy around the jugular foramen and skills specific to such surgery.