Jugular Foramen Schwannomas: Applied Anatomy to Diagnosis and Management

The jugular foramen (JF) is a complex region, and tumors affecting this area can extend toward both intra and extracranial spaces. Intracranially, tumors can project over posterior fossa and to middle ear structures, and can cause venous outflow disturbances, either by venous structures invasion or compression. Extracranially, they can involve the emerging segments of CN VII-XII, as well be close to important neurovascular structures as the carotid or vertebral arteries. The most common tumor of JF is paraganglioma, however a common subset of lesions comprises lower cranial nerves schwannomas. These lesions usually enlarge the foramen and compress surrounding structures, presenting with mass effect symptoms upon diagnosis due to a usually a slow-growing pattern, and microsurgical resection is most of the times the treatment of choice. Extensive laboratory training is essential to handle surgical approaches to JF properly.