Endoscopic Transoral Approach for Jugular Foramen Schwannoma

Objective: To describe the technique and outcome of the endoscopic transoral approach for jugular foramen schwannoma. Design: Case series, feasibility study, and technical report. Patients and Methods: Six patients with jugular foramen schwannoma (five females and one male, ages 16–63 years) were treated via a purely endoscopic transoral approach. Preoperatively, hypoglossal nerve paresis presented in five cases, glossopharyngeal nerve paresis in one case, hoarseness in one case, facial paralysis in one case, and hearing loss in two cases. Results: Radical resections of schwannomas were achieved in all six patients. The postoperative temporary complications included vagus palsy in two cases, swallowing difficulty in one case, and hypoglossal palsy in one case, which recovered 3 months after surgery. No patient experienced complications such as postoperative cerebrospinal fluid leak, meningitis, and cerebrovascular evidence. At the time of this review, the preoperative lingual motor dysfunction and muscular bulk had recovered, but hemiatrophy of the tongue was still detectable. The preoperative vagus palsy had recovered the 10th day after surgery. The hearing loss and facial palsy had completely recovered in 3 months postoperatively, and the swallowing function had improved. No patient in our series has experienced a recurrence for the follow-up period (9–17 months). Conclusions: With appropriate preoperative evaluation and careful planning of the perioperative period, complete resection of jugular foramen schwannoma can be achieved via a purely endoscopic transoral approach.