Nonvascular Tumors of the Jugular Foramen

Objective: Nonvascular lesions of the jugular foramen are rare lesions including meningiomas, schwannomas, and other rare lesions such as chondrosarcoma. The objective of this retrospective study was to analyze the management and outcome in a series of 56 cases collected at a single center. Setting: This study was conducted at a quaternary private otology and skull base center. Methods: A total of 56 charts belonging to patients with a diagnosis of nonvascular jugular foramen tumors between May, 1988 and April, 2012 were examined retrospectively. Results: One patient was managed with watchful expectancy. Of the patients surgically treated, 54% patients were operated on by the petro-occipital transsigmoid (POTS) approach. In the rest a combination of skull base procedures were performed. Complete tumor removal was accomplished in 95% of the cases. Postoperative facial nerve function was HB I in all patients operated on by the POTS approach. Good hearing was preserved in 83.3% cases, the majority of whom (58.3%) maintained their preoperative hearing level. There was no perioperative mortality. After surgery, a new deficit of one or more of the lower cranial nerves was recorded in 50% of the cases. Conclusions: Surgical resection is the treatment of choice. The POTS approach allowed single-stage, total tumor removal with preservation of the facial nerve and of the middle and inner ear functions in most of cases. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge.