Background: Lesions affecting the Jugular foramen other than paragangliomas are uncommon. Of those, schwannomas and meningiomas predominate with little data describing them in the literatures.
Aim: To evaluate the safety and efficacy of the Petro-occipital transsigmoid approach (POTS) for resection of nonvascular lesions of the jugular foramen.
Methods: descriptive study was conducted on 12 consecutive patients affected by various jugular foramen lesions, other than paragangliomas, were treated by POTS approach. All patients had a brain computed tomography (CT) scan, Magnetic resonant imaging (MRI) and magnetic resonant venography (MRV). Patients were followed up clinically by Karnofsky performance scale score and radiologically by CT, MRI images for average 1 year
Results: A single-stage resection was used for 12 patients; Schwannomas (6 cases), Meningiomas (3 cases), Chondrosarcomas (2 cases) and plasma cell tumor (1 case), using the POTS approach. This allowed adequate resection of both intra and extradural components of the tumor with hearing preservation and avoidance of facial nerve transposition. No deaths occurred. Variable grades of cranial nerve palsies were encountered, but none of the patients required an adjunctive procedure such as vocal cord medialization, tracheostomy, or percutaneous gastrostomy.
Conclusion: The POTS approach provided adequate tumor exposure for safe excision in a single staged procedure with access to both intracranial (extradural and intradural) and extracranial components, with moderate rates of hearing preservation and good rates of facial function preservation with minimal related morbidity.