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Optimal surgical approaches and treatment outcomes in patients with jugular foramen schwannomas: a single institution series of 31 cases and a literature review

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Abstract

Complete resection of jugular foramen schwannomas (JFSs) with minimal cranial nerve complications remains difficult even for skilled neurosurgeons. Between November 2011 and November 2017, 31 consecutive patients diagnosed with JFSs underwent a single-stage operation performed by the same neurosurgeon. We retrospectively analyzed clinical characteristics, surgical approaches, treatment outcomes, and follow-up data for these patients. JFSs were classified according to the Samii classification system. A retrosigmoid approach was used to resect type A tumors, while a suboccipital transjugular process (STJP) approach was used to resect type B tumors. Notably, the present study is the first to report the use of a paracondylar-lateral cervical (PCLC) approach for the treatment of type C and D tumors. Type A-D tumors were observed in seven, four, four, and 16 patients, respectively. Gross-total resection was achieved in 29 patients (93.5%). There were no cases of intracranial hematoma, re-operation, tracheotomy, or death. Adjunctive gamma knife treatment was used to manage residual tumors in two patients. Neurological deficits relieved in half of patients at the last follow-up. By reviewing the studies published on PubMed, the approaches gradually be more conservative, rather than widely expose the skull base. Nonetheless, endoscope and stereotactic radiosurgery plays an important role in the management of JFSs. Both tumor removal and neurological function retention can be obtained by choosing individual treatment.

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Acknowledgments

The authors appreciate Dr. Wenya Linda Bi for her suggestions on the manuscript.

Funding

This work was supported by grants from the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (grant number 2014BAI04B01) and the National Natural Science Foundation of China (grant number 81802974).

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Authors and Affiliations

  1. Department of Neurosurgery in Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China

    Xiangyu Wang, Wenyong Long, Dingyang Liu, Jian Yuan, Qun Xiao & Qing Liu

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  1. Xiangyu Wang
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  2. Wenyong Long
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  3. Dingyang Liu
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  4. Jian Yuan
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  5. Qun Xiao
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  6. Qing Liu
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Contributions

Conception and design: X.W., W.L., Q.L. Do the surgery procedure: all authors. Acquisition of data: X.W. Analysis and interpretation of data: X.W, Q.X. Drafting the article: X.W. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: X.W. Study supervision: Q.L.

Corresponding author

Correspondence to Qing Liu.

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The authors declare that they have no conflict of interest.

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This study was approved by the Research Ethics Committee of the Xiangya Hospital, Central South University.

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Informed consent was obtained from all individuals participants include in the study.

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Wang, X., Long, W., Liu, D. et al. Optimal surgical approaches and treatment outcomes in patients with jugular foramen schwannomas: a single institution series of 31 cases and a literature review. Neurosurg Rev 43, 1339–1350 (2020). https://doi.org/10.1007/s10143-019-01165-6

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  • DOI: https://doi.org/10.1007/s10143-019-01165-6

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