2011 Volume 21 Issue 3 Pages 256-260
Jugular foramen neuroma (JFN) is often misdiagnosed as vestibular schwannoma (VS) because the chief complaint and symptoms of JFN are quite similar to those of VS. If JFN is operated on under the wrong diagnosis, functional preservation is not achieved. On the contrary, if JFN is properly operated, hearing preservation and restoration after surgery is possible in many cases. In this paper, the results of the management of JFN and the mechanism of restoration after tumor removal is discussed.
Nine cases have been diagnosed and operated on by the author and collegues for JFN through far lateral approach. Hearing acuity before and after the surgery was examined by pure tone and speech audiometry, auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DP-OAE), and analysed in relation to the operative findings.
On the operation, the seventh and eighth nerves were clearly dissected from the tumor, thanks to arachnoid membrane in between. Hearing level was restored to almost normal range and speech discrimination score was restored to 95-100% in 8 out of 9 cases. In ABR, only wave I was detected before the surgery but waves I to V were well recognized after the surgery in some cases. The DP-OAE was detected before and after the surgery.
In conclusion, hearing can be well restored by the meticulous dissection during the surgical procedure of JFN provided the preoperative diagnosis is correct.
