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Juguler foramen nörinomlarının tedavisinde konservatif fasyal sinir yaklaşımı

CONSERVATIVE FACIAL NERVE MANAGEMENT IN JUGULAR FORAMEN SCHWANNOMAS

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Objective: Although transposition of the facial nerve is crucial in infiltrative, vascular lesions involving the jugular foramen, it was our objective to show that a conservative approach to management of the facial nerve is sufficient in jugular foramen neuromas because of their non-infiltrative, less vascular nature and medial location in the jugular foramen. Patients: Sixteen patients with jugular foramen schwannoma were treated (18 procedures) between January, 1975 and October, 1995. The eight males and eight females ranged in age from 13 to 66 years, with a mean age of 47.7 years. Intervention: One-stage, total jugular foramen neuroma removal without transposition of the facial nerve, using a variety of surgical approaches. Main Outcome Measures: Facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, complications. Results: One stage total tumor removal was accomplished in all of the cases. In 13 (72%) of the neuromas, removal was accomplished without facial nerve transposition. Transpos t on was performed n two rev s on cases to control the carot d artery completely, two cases with large tumor extension anteriorly to the petrous apex and one case w th extens ve nvolvement of the m ddle ear. A House-Brackmann fac al nerve grade I or II was obtained in 16 of the 18 procedures, with one grade III and one case which remained grade 9, as it was preoperatively. Conclusions: One stage, total tumor removal can be achieved with excellent control of the mportant vascular structures and w thout transpos t on of the fac al nerve n the major ty of jugular foramen schwannomas.
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Abstract (Original Language): 
Amaç: Juguler forameni tutan, infiltrative, vasküler lezyonların tedavisinde yeterli expojur için fasyal sinir transpozisyonu önemlidir. Bu çalışmadaki amacımız juguler foramen nörinomlarının vaskülaritesi az, non infiltratif ve juguler foramende medialde yerleşmes özell kler neden yle fasyal s n r transpoze etmeden tedav etmen n yeterl olacağını göstermektir. Hastalar: Ocak 1975 ile ekim 1995 arasında juguler foramen nörinomu nedeniyle tedav ed len 16 hasta (18 operasyon). Hastalar 8 erkek ve 8 kadın, 13 le 66 yaşları arasında idi, ortalama 47.7 yıl. Müdahele: Tek aşamalı fasyal siniri transpoze etmeden, çeşitli operasyonlarla total juguler foramen nörinomu eksizyonu. Ana değerlendirme kriterleri: Fasyal sinir traspozisyonu ( evet veya hayır), House-Brackmann fasyal sinir greydi, alt kranyal sinir durumu, komplikasyonlar. Bulgular: Tek aşamalı, tüm hastalarda total tümor eksizyonu gerçekleştirildi. On üç hastada (%72) fasyal siniri transpoze etmeden, juguler foramen nörinomu çıkartıldı. İki rev zyon vakada karot d arter tam kontrol ç n, d ğer olguda petroz apekse ulaşan çok büyük tümörlü iki hastada ve yaygın olarak orta kulağı tutan bir olguda transpozisyon uygulandı. On altı hastada House-Brackmann greyd 1 veya 2 fasyal sinir sonucu elde edildi, bir hasta da greyd 3, bir hastada preoperatif seviyesi olan greyd 5 olarak kaldı. Sonuç: Juguler foramen nörinomlarının tedavisinde, tek aşamalı olarak total tümor eks zyonu, fasyal s n r transpoze etmeden, vasküler yapıların mükemmel kontrolüyle yapılabilir.
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  • Turkish

REFERENCES

References: 

1. Horn KL, House W, Hitselberger WE. Schwannomas of the jugular foramen. Laryngoscope 1985 :761-5.
2. Graham MD, LaRouere MJ, Kartush JM. Jugular foramen schwannomas: Diagnosis and suggestions for surgical management Skull Base Surgery 1991, 1:34-8.
3. Crumley RL, Wilson C. Schwannomas of the jugular foramen. Laryngoscope 1984;772-8.
4. Kaye AH, Hahn JF, Kinney SE, Hardy RW, Bay JW. Jugular foramen schwannomas. J Neurosurg 1984, 60:1045-53.
5. Franklin DJ, Moore GF, Fisch U. Jugular foramen peripheral nerve sheath tumors. Laryngoscope 1989, 99 :1081-7.
6. Arenberg IK,McCreary HS. Neurilemmomas of the jugular foramen. Laryngoscope, 1971, 81:544-57
7. Gacek RR. Schwannomas of the jugular foramen. Ann Otol Rhinol Laryngol 1976;89:215-24.
8. Maniglia AJ, Chandler JR, Goodwin WJ et al . Schwannomas of the parapharyngeal space and the jugular foramen. Laryngoscope1979; 89: 1405-15.
9. Neely JG Reversible compression neuropathy of the eight cranial nerve from a large jugular schwannoma. Arch Otolaryngol 1979:105:555-60.
10. Kinney SE, Dohn DF, Hahn JFWood BG. Neuromas of the jugular foramen. In Neurologic surgery of the Skull Base. Brackmann DE. (Ed.) Raven Press New York, NY 1979;pp.361-7.
11. Raquet F, Mann W, Amedee R Maruer J, Gilsbach J. Functional deficits of cranial nerves in patients with jugular foramen lesions. Skull Base Surgery 1991;
1: 117-9.
12. Mann W, Amedee R, Gilsbach J, Perneczky A, Wolfensberger M. Transsigmoid approach for tumors of the jugular foramen. Skull Base Surgery,1991; 3:137-41.
13. Pluchino F, Crivelli G, Vaghi MA. Intracranial neurinomas of the nerves of the jugular foramen. Acta Neurochirurgica 1975; 31: 201-21.
14. Fisch U, Pilsbury HC. Infratemporal fossa approaches to lesions in the temporal bone and base of the skull Arch Otolaryngol 1979;105:99-107.
15. Brackmann DE. The facial nerve in the infratemporal approach Otolaryngol Head Neck Surg 1987;97:15-7.
16. Saleh E, Naguib M, Aristegui M, Cokkeser Y, Sanna M, Lower skull base: Anatomic study with surgical implications. Ann Otol Rhinol Laryngol 1995;104:
57-61.
17. Leonetti JP, Brackmann DE, Prass RL. Improved preservation of facial nerve function in the infratemporal approach to the skull base. Otolaryngol Head Neck Surg 1989; 101:74-8.
18. Jackson CG, Cueva RA, Thedinger BA, GlasscockME. Conservation surgery for glomus jugulare tumors:The value of early diagnosis. Laryngoscope 1990:1031¬6.
19. Leonetti JP, Brackmann DE. Glomus vagale tumor: The significance of early vocal cord paralysis. Otolaryngol Head Neck Surg 1989;100 :533-7.

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