Neurilemoma of the jugular foramen. Transmastoid removal

The authors present two cases in which the palsies of the IX, X, XI and XII nerves heralded the presence of a neurilemoma within the jugular foramen. Temporary bone polytomography, retrograde jugular venography, and pantopaque posterior fossa myelography allowed the nature and extent of the tumor to be predicted accurately prior to the operation. The tumors were completely removed using a transmastoid-extended facial recess approach without labyrinthectomy, supplemented in one case by exploration of the upper cervical portion of the internal jugular vein. This technique has avoided the complications which attend removal by way of the posterior fossa. We feel that transmastoid removal merits more extensive clinical trial.