目的：本研究的目的是评估采用改良手术技术、面神经无张力前路改道以及岩下窦隧道填塞或推压填塞术治疗颈静脉孔副神经节瘤（JFP）的安全性和有效性。方法：对2010年10月至2021年6月在复旦大学眼耳鼻喉科医院（中国上​​海）治疗的88例JFP患者进行回顾性分析，对手术结果进行肿瘤分类分析。 、术中情况以及术后面神经（FN）和下颅神经（​​LCN）的功能。结果：本研究共纳入88例患者，其中获得大体全切除70例（79.5%），接近全切除17例（19.3%），次全切除1例。术中平均失血量为448.3 mL。此外，24例患者接受了手术全前路改道（TAR），18例患者接受了手术全FN无张力前路改道（TF-TAR），18例患者接受了手术FN部分FN无张力前路改道（TF-PAR）。 TAR组术后FN功能良好（House-Brackmann Ⅰ-Ⅱ）为62.5%。在 TF-TAR 和 PF_TAR 组中，88.9% 的患者术后 FN 功能良好。应用无张力FN前路改道技术后FN功能明显改善（P=0.007）。 20例患者（22.7%）在术前评估中存在至少一项LCN缺陷。术后LCN功能障碍与肿瘤Fisch分类相关，C1-C2级LCN功能障碍发生率较低（4.9%，2/41例），C3-D级LCN功能障碍预后较差（8.5%,4） /47例），在早期肿瘤中对LCN功能的影响可能较小。结论:应用FN无张力前路改道和岩下窦隧道填塞改良手术技术可有效保留FN和LCN功能,减少术中失血量,最终提高患者术后质量《临床耳鼻咽喉头颈外科杂志》编辑部版权所有©。

Objective:The aim of this study is to evaluate the safety and efficacy of surgical interventions ofjugular foramen paragangliomas（JFP） utilizing modified surgical techniques, tensionfree anterior rerouting of the facial nerve and tunnel-packing or push-packing of the inferior petrous sinus. Methods:A retrospective analysis was conducted on a cohort of 88 patients diagnosed with JFP and treated at the Eye Ear Nose and Throat Hospital of Fudan University（in Shanghai, China） from October 2010 to June 2021. The surgical outcomes were analyzed for tumor classification, intraoperative conditions, and function of the postoperative facial nerve（FN） and lower cranial nerve（LCN）. Results:The study included a total of 88 patients, gross total resection was achieved in 70 patients（79.5%）, near total resection was obtained in 17 patients（19.3%）, and one patient undergoing subtotal resection. The average of intraoperative blood loss was 448.3 mL. Additionally, 24 patients underwent surgical total anterior rerouting（TAR）, 18 patients underwent surgical total FN tension free anterior rerouting（TF-TAR）, and 18 patients underwent surgical FN partial FN tension free anterior rerouting（TF-PAR）. Good postoperative FN function（House-Brackmann Ⅰ-Ⅱ） was achieved in 62.5% of TAR group. In the TF-TAR and PF_TAR groups, good postoperative FN function was demonstrated in 88.9% patients. It showed a significantly improvement of the FN function following application of tension-free FN anterior rerouting technique（P=0.007）. Twenty patients（22.7%） suffered from at least one LCN deficit in the preoperative evaluation. The postoperative LCN deficits was correlated with the Fisch classification of tumors, which showed a lower incidence of LCN dysfunction in classes C1-C2（4.9%, 2/41cases） and poorer outcomes of LCN dysfunction in classes C3-D（8.5%,4/47cases ）, it was likely less impacted the LCN function in the early stage tumor. Conclusion:The application of modified surgical techniques of FN tension-free anterior rerouting and tunnel-packing of the inferior petrous sinus has been shown to effectively preserve the function of the FN and LCN, decrease intraoperative blood loss, and ultimately improve patients' postoperative quality of life.Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.