Jugular Foramen Schwannomas: Long-Term Follow-Up

Fewer than 400 cases of jugular foramen schwannomas have been reported in the literature. No consensus exists on their management. They are treated either by watchful expectancy, surgical removal, or radiosurgery. In this retrospective study we present 19 jugular foramen schwannomas, which were followed for up to 24 years. All tumors were microsurgically radically removed in one- or two-session operations. The operative approach was chosen according to the type of the tumor: A (intracranial), B (intraosseous), C (extracranial), or D (saddleback-dumbbell-shaped) according to Kaye et al (1984) and Pellet et al (1988). Intraoperative monitoring is helpful to reduce the risk of injury of neural structures. Each patient was carefully monitored before, during, and after the surgery. Five of those 19 patients were unsuccessfully treated before the operation by several different methods including stereoradiosurgery by Leksell Gamma Knife (LGK). Our postoperative follow-up did not show any mortality, just tolerable lesions of nerves IX, X, XI and only two tumor recurrences 11 and 14 years after the first surgery. They were successfully reoperated. We conclude that microsurgical radical removal of jugular foramen schwannomas is superior to all other methods of treatment including stereoradiosurgery.