Complications of Lateral Skull Base Surgery

Pathological conditions involving the lateral skull base potentially endanger the lower six cranial nerves. The resulting neurological deficit often has a devastating effect on the quality of life of the patient. Similarly any surgery or radiotherapy used in the management of such patients may further aggravate the situation.

The initial surgery of the cerebellopontine angle was complicated by facial palsy and deafness. Fortunately balance problems were generally self-limiting due to central compensation. With the development of more radical petrous bone surgery, neuropathies of the nerves of the jugular foramen have become more common. Sadly, the result of the jugular foramen syndrome on the quality of life seems to have been minimized in most reports.

This paper reviews the literature and illustrates why these problems are often under-rated by many doctors and overtreated by speech and language therapists.

A protocol for the management of the problems of a postoperative jugular foramen syndrome is presented along with a surgical method of rehabilitation.