Abstract
Tumors of the jugular foramen remain challenging lesions despite advances in surgical technique and medical technology. Tumors with extensive extra- and intracranial components necessitate both radical neck dissection maneuvers combined with skull base approaches. We present a single surgeon’s perspective in managing these difficult tumors.
Highlights
Due to its deep location in the skull base with its associated intricate interweaving of neural and vascular structures, the jugular foramen remains very difficult and hazardous to access in modern neurosurgery
The removal of a large tumor of the jugular foramen with significant extracranial component requires a combination of skull base approaches
Most of these techniques involve the mobilization of cranial nerves and ligation of the jugular vein and sigmoid sinus [1]
Summary
Due to its deep location in the skull base with its associated intricate interweaving of neural and vascular structures, the jugular foramen remains very difficult and hazardous to access in modern neurosurgery. The removal of a large tumor of the jugular foramen with significant extracranial component requires a combination of skull base approaches. Most of these techniques involve the mobilization of cranial nerves and ligation of the jugular vein and sigmoid sinus [1]. An MRI performed showed an enhancing, dural-based tumor centered on the left jugular foramen, impinging on the brainstem (Figure 5). Over a prolonged follow-up, the patient’s swallowing function improved and she remains asymptomatic without need of her PEG tube, eating normally She is being followed with a stable residual tumor on serial imaging (Figure 6). Postoperative MRI with contrast depicting a near total gross resection of the jugular foramen lesion via a retrosigmoid approach. The patient continues to use a gastrostomy for feeding at most recent follow-up
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