[Management of jugular foramen XXXX ].

@entity808 @entity1 @entity129 @entity41 @entity5 @entity2103 @entity4048 @entity1282 @entity10
OBJECTIVE: To discuss surgical approach selection and treatment strategy for preservation of the facial and lower cranial nerves' function in jugular foramen @entity808 surgery. METHODS: Retrospectively analyzed the clinical presentation, surgical approaches selection, facial and lower cranial nerves follow-up outcomes of 38 jugular foramen @entity808 , who received operations in the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital affiliated to Shanghai Jiaotong University, School of Medicine during 2002 and 2012. RESULTS: A total of 38 @entity1 , including 18 @entity1 and 20 @entity1 , with ages ranged from 21 to 70 years (mean 45.3). @entity10 or @entity4048 in preoperative clinical presentation was present in 27 @entity1 (71.1%) and cervical mass in 9 @entity1 (23.7%). @entity129 , mainly the vagus nerve, were present in 21 @entity1 (55.3%). MRI finding: 19 @entity5 were intra- and extracranial, 10 were intracranial and 9 were extracranial. According to the @entity5 location and region, select the surgical approaches. 25 @entity1 used infratemporal fossa type A approach, 5 @entity1 used petrous occipital transsigmoid approach and 8 @entity1 used transcervial approach to remove @entity5 . The percentage of total resection was 92.1% (35/38). Adjunctive radiosurgery was used in the management of @entity41 in two @entity1 . All cases obtained ultimately @entity5 control. @entity1 were followed by MRI every 6 months for 1 year. Thereafter, they performed follow-up imaging every 1-2 years, and the @entity129 was analyzed and evaluated. They were followed up from 26-124 months (median follow-up was 62.3 months). During follow-up period, good facial function was obtained in 36 @entity1 (94.7%). All @entity1 had no @entity1282 . Complete compensation of lower @entity129 was achieved in all @entity1 . CONCLUSIONS: The preoperative estimation and location of @entity5 in nature is of great importance in the determination of proper surgical planning of jugular foramen @entity808 . @entity2103 and lower @entity129 can be preserved in maximal degree by proper surgical approaches and careful operative manipulation. Initial surgical resection followed by radiosurgery may be an effective option for some special @entity1 .
