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J Neurol Surg B Skull Base
DOI: 10.1055/a-2215-6209
Original Article

Outcomes after Surgical Resection of Jugular Foramen Schwannomas: Systematic Review and Meta-Analysis

Haydn Hoffman
1   Department of Neurosurgery, State University of New York Upstate Medical University, Syracuse, New York, United States
,
Brendan B. Maloney
1   Department of Neurosurgery, State University of New York Upstate Medical University, Syracuse, New York, United States
,
Dan Y. Draytsel
1   Department of Neurosurgery, State University of New York Upstate Medical University, Syracuse, New York, United States
,
Harish Babu
1   Department of Neurosurgery, State University of New York Upstate Medical University, Syracuse, New York, United States
› Author Affiliations Funding None.
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Abstract

Objectives We sought to perform a systematic review and meta-analysis of outcomes after surgical resection of jugular foramen schwannomas (JFSs).

Design A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Setting PubMed, Scopus, and Embase databases were searched.

Participants Case series of at least five patients undergoing surgical resection of JFSs were included.

Main Outcome Measures Primary outcomes included gross total resection (GTR) and near total resection (NTR) rates, as well as a composite of the two (GTR + NTR). Additional outcomes included new or worsening cranial nerve (CN) palsies and cerebrospinal fluid (CSF) leak. Random effects models were used to generate pooled outcomes.

Results A total of 25 studies comprising 567 patients were included in the study. The proportions of each tumor grade were the following: grade A (33.1%), grade B (16.1%), grade C (9.2%), and grade D (41.6%). The pooled rate of GTR was 81% (95% confidence interval [CI]: 70–88; I 2 = 78.9%) and the composite GTR + NTR rate was 88% (95% CI: 81–93; I 2 = 66.4%). Rates of new or worsening CN palsies were the following: 12% hearing loss (95% CI: 7–20; I 2 = 69.4%), 27% dysphagia (95% CI: 20–36; I 2 = 66%), 20% hoarseness (95% CI: 14–28; I 2 = 62.6%), and 19% facial palsy (95% CI: 13–28; I 2 = 64.6%). The pooled rate of CSF leak was 9% (95% CI: 6–15; I 2 = 43.9%).

Conclusion The literature suggests high GTR rates of JFSs can be achieved. However, new CN deficits are not uncommon.

Keywords

schwannoma - jugular foramen - resection - microsurgery

Supplementary Material



Publication History

Received: 15 July 2023

Accepted: 20 November 2023

Accepted Manuscript online:
22 November 2023

Article published online:
13 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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