Nowak Arkadiusz, Dziedzic Tomasz, Czernicki Tomasz, Kunert Przemysław, Marchel Andrzej
Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, Warszawa, Poland.
Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, Warszawa, Poland.
Neurol Neurochir Pol. 2014;48(6):391-6. doi: 10.1016/j.pjnns.2014.09.008. Epub 2014 Oct 16.
We present our experience with surgery of jugular foramen meningiomas with special consideration of clinical presentation, surgical technique, complications, and outcomes.
This retrospective study includes three patients with jugular foramen meningiomas treated by the senior author between January 2005 and December 2010. The initial symptom for which they sought medical help was decreased hearing. In all of the patients there had been no other neurological symptoms before surgery. The transcondylar approach with sigmoid sinus ligation at jugular bulb was suitable in each case.
No death occurred in this series. All of the patients deteriorated after surgery mainly due to the new lower cranial nerves palsy occurred. The lower cranial nerve dysfunction had improved considerably at the last follow-up examination but no patient fully recovered. Two of three patients with preoperatively impaired yet functional hearing deteriorated after surgery with no subsequent cranial nerve VIII function improvement. In one case postoperative stereotactic radiosurgery was performed due to non-radical tumour resection (Simpson Grade IV) and tumour remnant proved stable in the 4-year follow-up. None of the patients have shown signs of tumour recurrence in the mean follow-up period of 56 months.
Jugular foramen meningiomas represent one of the rarest subgroups of meningiomas and their surgical treatment is associated with significant risk of permanent cranial nerve deficits.
我们介绍了颈静脉孔脑膜瘤的手术经验，特别考虑了临床表现、手术技术、并发症和结果。
这项回顾性研究包括2005年1月至2010年12月期间由资深作者治疗的3例颈静脉孔脑膜瘤患者。他们寻求医疗帮助的初始症状是听力下降。所有患者在手术前均无其他神经症状。在每种情况下，经髁入路并在颈静脉球处结扎乙状窦均适用。
该系列中无死亡病例。所有患者术后均出现恶化，主要是由于出现了新的低位颅神经麻痹。在最后一次随访检查时，低位颅神经功能障碍有了相当大的改善，但没有患者完全恢复。3例术前听力受损但仍有功能的患者中有2例术后听力恶化，且术后第八颅神经功能未改善。1例因肿瘤切除不彻底（辛普森四级）而进行了术后立体定向放射外科治疗，在4年的随访中肿瘤残余稳定。在平均56个月的随访期内，没有患者出现肿瘤复发迹象。
颈静脉孔脑膜瘤是脑膜瘤中最罕见的亚组之一，其手术治疗伴有永久性颅神经缺损的重大风险。
