Transjugular transsigmoid approach for triple dumbbell-shaped jugular foramen schwannomas.

Abstract

Jugular foramen tumors, particularly those that are triple dumbbell-shaped with intracranial, intraforaminal, and extracranial extensions, are difficult to access surgically. However, advances in neuroimaging, neuromonitoring, and skull base surgery have enabled their safe resection with lower rates of morbidity and mortality. We share our experience with the surgical technique for the management of triple dumbbell-shaped jugular foramen schwannomas. The infralabyrinthine transjugular transsigmoid approach with high cervical exposure under continuous vagus nerve monitoring enables gross total resection of triple dumbbell-shaped jugular foramen schwannomas, aiming at surgical cure of these benign tumors for appropriately selected patients.