Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Pure endoscopic presigmoid infralabyrinthine approach for jugular foramen tumors: Operative technique and early results.
СтатьяНазвание и аннотация: Перевод в очереди
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Chen Pin, Xie Tao, Yang Qiaoqiao, Yan Chaolong, Liu Tengfei, Li Zeyang, Liu Shuang, Xie Qiang, Huang Jinglong, Wang Cunzu, Zhang Xiaobiao
Аннотация
BACKGROUND: Jugular foramen (JF) tumors are uncommon, often requiring surgical resection due to their complex anatomical location and varied growth patterns, particularly when intraosseous.
OBJECTIVE: We propose the pure endoscopic presigmoid infralabyrinthine approach (EPSIL) as a minimally invasive technique for lateral JF access during tumor resection, circumventing the need for extensive exposure of vital structures and jugular vein sacrifice.
METHODS: A retrospective analysis was conducted on six patients who underwent EPSIL for JF tumor resection since 2020. The focus was on operative techniques, extent of tumor removal, neurological outcomes, and approach-related morbidity.
RESULTS: The cohort included six patients (three male, three female) with an average age of 46.9 years and a follow-up of 21.6 months. Tumor types were four schwannomas, one paraganglioma, and one chondrosarcoma (WHO grade 2), with average dimensions of 41.2 × 18.8 × 34.5 mm. All were successfully removed via EPSIL, aided by neuro-navigation and monitoring. Four achieved gross-total resections, two subtotal (>90 %), with the latter treated with Gamma Knife for remnants. No tumor recurrence or growth was noted. Preoperative symptoms improved postoperatively, with temporary hoarseness and slight hearing impairment resolving within 8 weeks. One patient had a cerebrospinal fluid leak, managed with a lumbar drain, without long-term deficits.
CONCLUSION: The EPSIL approach is a highly effective method for the removal of JF tumors, particularly those with intraosseous growth. It stands out as a minimally invasive procedure that harmoniously integrates radical tumor resection with the preservation of cranial nerves.
OBJECTIVE: We propose the pure endoscopic presigmoid infralabyrinthine approach (EPSIL) as a minimally invasive technique for lateral JF access during tumor resection, circumventing the need for extensive exposure of vital structures and jugular vein sacrifice.
METHODS: A retrospective analysis was conducted on six patients who underwent EPSIL for JF tumor resection since 2020. The focus was on operative techniques, extent of tumor removal, neurological outcomes, and approach-related morbidity.
RESULTS: The cohort included six patients (three male, three female) with an average age of 46.9 years and a follow-up of 21.6 months. Tumor types were four schwannomas, one paraganglioma, and one chondrosarcoma (WHO grade 2), with average dimensions of 41.2 × 18.8 × 34.5 mm. All were successfully removed via EPSIL, aided by neuro-navigation and monitoring. Four achieved gross-total resections, two subtotal (>90 %), with the latter treated with Gamma Knife for remnants. No tumor recurrence or growth was noted. Preoperative symptoms improved postoperatively, with temporary hoarseness and slight hearing impairment resolving within 8 weeks. One patient had a cerebrospinal fluid leak, managed with a lumbar drain, without long-term deficits.
CONCLUSION: The EPSIL approach is a highly effective method for the removal of JF tumors, particularly those with intraosseous growth. It stands out as a minimally invasive procedure that harmoniously integrates radical tumor resection with the preservation of cranial nerves.