Artikel
Surgical treatment of selected tumours via the navigated minimally invasive presigmoidal suprabulbar infralabyrinthine approach without rerouting of the facial nerve
Chirurgische Behandlung ausgewählter Tumore durch den neuronavigierten minimal-invasiven presigmoidalen suprabulbären infralabyrinthären Zugang ohne Verlagerung des Nervus facialis
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Autoren
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Zafer Cinibulak
- Krankenhaus Köln-Merheim, Klinikum der Universität Witten/Herdecke, Klinik für Neurochirurgie, Köln, Deutschland
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Shadi Al-Afif
- Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
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Makoto Nakamura
- Krankenhaus Köln-Merheim, Klinikum der Universität Witten/Herdecke, Klinik für Neurochirurgie, Köln, Deutschland
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Joachim K. Krauss
- Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
| Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: The feasibility of the navigated presigmoidal suprabulbar infralabyrinthine approach without rerouting of the fallopian canal for selected jugular foramen tumors (JFTs) has been described in our previous study. Here, we present our clinical experience with this approach for selected JFTs, with a particular focus on its efficacy and safety.
Methods: Patients with JFTs treated via the navigated presigmoidal suprabulbar infralabyrinthine approach have been included to this study. The JFTs were classified according to a modified Fisch classification. The neurological and neuroradiological outcome, the extent of tumor resection, and the approach-related morbidity were examined.
Results: Five patients (two women, three men; mean age 57y, range 48-65) had been included to this study. According to a modified Fisch classification, two JFT were graded as C1, one as De1 and two as De2. Gross total resection (GTR) was achieved in three patients (benign fibrose lesion, cholesterolgranuloma, chondrosarcoma) and near-total resection (NTR) in two (metastasis of a clear cell renal cell carcinoma, chordoma). Postsurgically, no new neurological deficits and no approach-related morbidity and mortality were noticed. During the follow-up period (mean 70,6 months, range 12-132 months) tumor-recurrence was noted in the NTR group and no tumor-recurrence was noted in the GTR group. One case with postoperative cerebrospinal fluid leak was managed successfully with lumbar drainage.
Conclusion: The neuronavigated presigmoidal suprabulbar infralabyrinthine approach to the jugular foramen without rerouting of the fallopian canal is suitable for selected tumors of the jugular foramen. It allows safe and complete removal with minimal approach-related complications.
