Surgical treatment of glossopharyngeal nerve schwannomas: Results of two-center study (14 patients included) and literature review




cerebellopontine angle, jugular foramen, non-vestibular schwannoma, glossopharyngeal schwannoma, caudal cranial nerves group schwannoma, diagnosis, clinical picture, cranial nerves


Objective: This study is aimed to analyze the outcomes of surgical treatment of glossopharyngeal schwannomas based on pre- and postoperative neurological status assessment.

Materials and methods: This paper is a retrospective analysis of examination and surgical treatment of 14 patients who were operated on in two large clinics from 2018 to 2021 inclusive. When analyzing the collected data, gender, age, disease symptoms, tumor size and location, surgical approach, tumor to cranial nerves (CN) ratio, jugular foramen (JF) condition, and tumor removal volume were taken into account. All tumors were divided into groups depending on tumor location relative to the JF. Particular attention was paid to assessing cranial nerves functions. Facial nerve function was assessed as per House-Brackmann Scale (HBS), hearing function as per Gardner-Robertson Scale (GRS).

Results: 3 (21.4%) patients had total tumor removal: 2 patients had type A tumors and one had type B tumor. Subtotal resection took place in 7 (50%) cases. In 4 cases, a tumor was partially removed: 3 patients had type D tumors and one had type B tumor.

3 (21.4%) patients had preoperative FN deficit (HBS Grade II) and mild dysfunction. 5 (35.7%) patients had postoperative facial nerve deficit: HBS ІІ, 2; ІІІ, 1; V, 2.

Preoperative sensorineural type hearing impairment on the affected side was diagnosed in 13 (92.6%) patients. Before surgery, 6 patients had non-serviceable hearing, which remained at the same level after surgery. None of the patients with grade I or II hearing before surgery had any hearing impairment postoperatively. In 2 (14.3%) cases, hearing improved from grade V to grade III after surgery.

6 (42.9%) patients developed new neurological deficit in the caudal group CN. Postoperative deficit of the caudal group CN occurred in type D tumors in 3 patients, type A tumors 2 patients, and type B tumors one patient.

Conclusions: Applying a retrosigmoid approach only makes it possible to achieve total tumor removal in case of type A tumors. To remove other tumor types, it is necessary to select approaches that enable access to the jugular foramen and infratemporal fossa. Intraoperative neurophysiological monitoring is an extremely important tool in glossopharyngeal schwannoma surgery.

The most common postoperative complication is a developed or increased deficit of the caudal CN group, which can lead to persistent impairments in the patients’ quality of life. Preservation of the CN VII and VIII function in most cases is a feasible task and shall be ensured as a standard for this pathology.


Sanna, M., Bacciu, A., Falcioni, M., & Taibah, A. (2006). Surgical Management of Jugular Foramen Schwannomas With Hearing and Facial Nerve Function Preservation: A Series of 23 Cases and Review of the Literature. The Laryngoscope, 116(12), 2191–2204. doi:10.1097/01.mlg.0000246193.843

Ramina, R., Maniglia, J. J., Fernandes, Y. B., Paschoal, J. R., Pfeilsticker, L. N., & Neto, M. C. (2005). Tumors of the Jugular Foramen: Diagnosis and Management. Operative Neurosurgery, 57, 59–68. doi:10.1227/01.neu.0000163483.447

Samii M, Alimohamadi M, Gerganov V. Surgical Treatment of Jugular Foramen Schwannoma: Surgical Treatment Based on a New Classification. Neurosurgery. 2015 Sep;77(3):424-32; discussion 432. doi: 10.1227/NEU.0000000000000831

Wilkins RH, Rengachary SS, editors. 2nd ed., Neurosurgery, vol. 2, 2nd ed. New York: McGraw-Hill; 1996. p. 1553–7.

Kadri PA, Al-Mefty O. Surgical treatment of dumbbell-shaped jugular foramen schwannomas. Neurosurg Focus. 2004 Aug 15;17(2):E9. doi: 10.3171/foc.2004.17.2.9

Nowak A, Dziedzic T, Czernicki T, Kunert P, Marchel A. Surgical treatment of jugular foramen schwannomas. Neurol Neurochir Pol. 2014;48(3):188-95. doi: 10.1016/j.pjnns.2014.05.004

Kankane VK, Warade AC, Misra BK. Nonvestibular Schwannoma Tumors in the Cerebellopontine Angle: A Single-Surgeon Experience. Asian J Neurosurg. 2019 Jan-Mar;14(1):154-161. doi: 10.4103/ajns.AJNS_335_17

Sedney CL, Nonaka Y, Bulsara KR, Fukushima T. Microsurgical management of jugular foramen schwannomas. Neurosurgery. 2013 Jan;72(1):42-6; discussion 46. doi: 10.1227/NEU.0b013e3182770e74

Samii M, Migliori MM, Tatagiba M, Babu R. Surgical treatment of trigeminal schwannomas. J Neurosurg. 1995 May;82(5):711-8. doi: 10.3171/jns.1995.82.5.0711

Kano H, Meola A, Yang HC, Guo WY, Martínez-Alvarez R, Martínez-Moreno N, Urgosik D, Liscak R, Cohen-Inbar O, Sheehan J, Lee JYK, Abbassy M, Barnett GH, Mathieu D, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for jugular foramen schwannomas: an international multicenter study. J Neurosurg. 2018 Oct;129(4):928-936. doi: 10.3171/2017.5.JNS162894

Ryu SM, Lee JI, Park K, Choi JW, Kong DS, Nam DH, Jeong HS, Cho YS, Seol HJ. Optimal treatment of jugular foramen schwannomas: long-term outcome of a multidisciplinary approach for a series of 29 cases in a single institute. Acta Neurochir (Wien). 2017 Aug;159(8):1517-1527. doi: 10.1007/s00701-017-3230-0

Wilson, M.A., Hillman, T.A., Wiggins, R.H. and Shelton, C. (2005), Jugular Foramen Schwannomas: Diagnosis, Management, and Outcomes. The Laryngoscope, 115: 1486-1492.

Zeng XJ, Li D, Hao SY, Wang L, Tang J, Xiao XR, Meng GL, Jia GJ, Zhang LW, Wu Z, Zhang JT. Long-Term Functional and Recurrence Outcomes of Surgically Treated Jugular Foramen Schwannomas: A 20-Year Experience. World Neurosurg. 2016 Feb;86:134-46. doi: 10.1016/j.wneu.2015.09.104

Wang X, Long W, Liu D, Yuan J, Xiao Q, Liu Q. Optimal surgical approaches and treatment outcomes in patients with jugular foramen schwannomas: a single institution series of 31 cases and a literature review. Neurosurg Rev. 2020 Oct;43(5):1339-1350. doi: 10.1007/s10143-019-01165-6




How to Cite

Sirko, A. H., Lisianyi, O. M., Skobska О. Y., Malyi, R. R., Popovych, I. O., & Zemskova, O. V. (2021). Surgical treatment of glossopharyngeal nerve schwannomas: Results of two-center study (14 patients included) and literature review. Ukrainian Neurosurgical Journal, 27(4), 23–29.



Original articles