Tomio S, Takakura K
Skull Base Surg. 1991;1(3):152-60. doi: 10.1055/s-2008-1056998.
Twelve patients with jugular foramen neurinoma were operated on at our clinic between 1974 and 1990. The initial signs and symptoms were variable; dysfunctions of the 7th, 8th, 9th, 10th, and 11th nerves were frequently observed. Among these, involvement of the eighth nerve was most frequent, and three patients were given a misdiagnosis of acoustic neurinoma. Computed tomography scan and magnetic resonance imaging were useful not only for the correct diagnosis, but also for planning the surgical treatment and postoperative followup. Surgical resection was accomplished with four different approaches: (1) suboccipital approach without opening the jugular foramen, (2) suboccipital approach with opening the jugular foramen, (3) suboccipital approach with opening the jugular foramen combined with infralabyrinthine approach, (4) infralabyrinthine approach. The surgical approach depended on the presence of intracranial tumor and on the extent of extracranial involvement. There was no operative mortality. Dysfunction of the 8th, 9th, 10th, or 11th nerve did not improve in any patient after tumor removal. In contrast, 12th nerve palsy improved in two of three patients after tumor removal. The nerve of origin was identified in five cases; those were from the ninth nerve in three and from the 11th nerve in two.
1974年至1990年间，我院对12例颈静脉孔神经鞘瘤患者进行了手术治疗。最初的体征和症状各不相同；常观察到第7、8、9、10和11对神经功能障碍。其中，第八对神经受累最为常见，有3例患者被误诊为听神经瘤。计算机断层扫描和磁共振成像不仅有助于正确诊断，还有助于规划手术治疗和术后随访。采用四种不同的手术入路进行手术切除：（1）枕下入路不打开颈静脉孔；（2）枕下入路打开颈静脉孔；（3）枕下入路打开颈静脉孔联合迷路下入路；（4）迷路下入路。手术入路取决于颅内肿瘤的存在情况和颅外受累程度。无手术死亡病例。肿瘤切除后，所有患者的第8、9、10或11对神经功能障碍均未改善。相比之下，3例患者中有2例在肿瘤切除后第12对脑神经麻痹有所改善。在5例病例中确定了肿瘤起源神经；其中3例起源于第九对神经，2例起源于第11对神经。
