OBJECTIVETo investigate the diagnosis and surgical treatment of lower cranial schwannomas of jugular foramen.

METHODSRetrospective review of 11 cranial schwannomas of jugular foramen which received surgical removal from November 2001 to June 2005. According to classification, 5 cases were as intracranial type, 3 as jugular foramen type, 1 as neck extension type and the other 2 as combination type. Surgical procedures composed of 3 translabyrinthine, 2 retrosigmoid and 6 subtemporal fossa approach.

RESULTSOne-stage total tumor removal was accomplished in all the cases without any severe complications. Residue hearing was preserved in two cases received retrosigmoid approach. Anatomic completion of facial nerve was maintained in all the cases. Lower cranial neuropathy was found in 9 cases before surgery and occurred in all the cases after surgery. During in-hospital period complete compensation of swallowing ability was gained in 7 cases, near total, partial compensation and total decompensation was found in 1, 2 and 1 cases, respectively. Followed-up for 6 months, 10 cases caught normal swallowing function while the other one with partial compensation. Hoarseness was occurred in all the cases immediately after surgery and improved during follow-up. CSF leakage was occurred in 2 cases, no intracranial infection was found in all the cases.

CONCLUSIONSSurgical treatment was the optimal management to cranial schwannoma of jugular foramen. Surgical approach selections depends on tumor classification on magnetic resonance imaging features. Nerve protection in surgery and postoperative rehabilitation were the key to better prognosis.