Objective: Although trarıspositiorı of the facial neve is crucial in infiltrative, vascular lesions involving the jugular foramen, it was our objective to show that a conservative approach to management of the facial nerve is sufficient in jugular foramen neuromas because of their non-infiltrative, less vascular nature and medial location in the jugular foramen.
Patients: Sixteen patients with jugular foramen schwannoma were treated (18 procedures) between January, 1975 and October, 1995. The eight males and eight females ranged in age from 13 to 66 years, with a mean age of 47.7 years. InterventLon: One-stage, total jugular foramen neuroma removal w thout transposition of the facial nerve, using a variety of surgical approaches.
Main Outcome Measures: Facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, compiications.
Results: One stage total tumor removal was accompiished in all of the cases. In 13 (72%) of the neuromas, removal was accompiished wıthout facial nerve transposition. Transposition was performed in two revision cases to control the carotid artery completely, two cases with large tumor extension anteriorly to the petrous apex and one case with extensive involvement of the middle ear. A House-Brackmann facial nerve grade I or II was obtained in 16 of the 18 procedures, w i th one grade III and one case which remained grade 9, as it was preoperatively.
Conclus ons: One stage, total tumor removal can be ach eved w th excellent control of the important vascular structures and without transposition of the facial nerve in the majority of jugular foramen schwannomas.
Key words: Facial nerve, schwannoma, jugular foramen
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