Extirpation of a jugular foramen schwannoma via the transcervical-transmandibular approach

Schwannomas of the jugular foramen are rare lesions. We present a case of a schwannoma of the spinal accessory nerve that occurred in the jugular foramen and skull base of a 52-year-old woman. The tumor was completely extirpated via a transcervical-transmandibular approach with an excellent functional result. The approach used afforded excellent exposure of the lateral or midline skull base, as well as maximum control of the major neurovascular structures in the upper neck and skull base.     

Safety of tongue base procedures for sleep apnoea in adults: A systematic review and metanalysis from the YO-IFOS study group

ObjectiveTongue base and hypopharynx are the major sites of obstruction in OSA patients with failed palatal surgery. In recent years, several minimally invasive procedures have been developed to address tongue base obstruction. However, the research focus has consistently been on the effectiveness of surgery in reducing obstructive sleep apnoea rather than on postoperative complications. In this systematic review and metanalysis we aim to review the complication rate of minimally invasive base of tongue procedures for OSAS in adults.Data sourcesPubMed (Medline), the Cochrane Library, EMBASE, Scopus, SciELO and Trip Database.Review methodsData sources were checked by three authors of the YO-IFOS sleep apnoea study group. Three authors extracted the data. Main outcome was expressed as the complication rate and 95% confidence interval for each surgical technique.Results20 studies (542 patients) met the inclusion criteria. The mean complication rate is 12.79%; 4.65% for minor complications, 6.42% if they are moderate, and 1.77% if severe. The most reported complication overall is infection, in 1.95% of cases, followed by transient swallowing disorder, occurring in 1.30% of the total sample.ConclusionThe heterogeneity amongst the included studies prevents us from obtaining solid conclusions. The available evidence suggests that minimally invasive base of tongue procedures may present a wide spectrum of complication rates, ranging from 4.4% in tongue base radiofrequency to up to 42.42% in tongue base ablation.