Abstract
We discuss an optimal therapy for jugular foramen schwannomas (JFSs) designed to minimize the risk of neurological deficit, based on tumor location, shape and size. We treated fourteen patients with JFSs in this study. They were classified into two types according to tumor location; intradural (ID) and intra/extradural (ID/ED). In cases without brainstem compression, the patient was treated by gamma knife radiosurgery (GKRS). Conversely, where compression was evident, surgery was initially performed. In compressed ID cases, the intracisternal portion was resected using a lateral suboccipital approach, followed by GKRS for the residual tumor in the JF. In ID/ED cases, the transjugular approach was primarily used, in addition to the transcervical where there was upper cervical extension. While the six symptomatic cases showed little or no post-surgical improvement, the eight asymptomatic cases yielded no posttreatment deficit. These results indicate that a combined treatment strategy chosen according to tumor shape, location and size is a very effective treatment modality for JFSs.
