MISCELLANEOUS Comparative results of infratemporal fossa approach with or without facial nerve rerouting in jugular fossa tumors J. L. Llorente • S. Obeso • F. Lo ´pez • J. C. Rial • A. Coca • C. Sua ´rez Received: 17 March 2013 / Accepted: 15 July 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract Jugular fossa tumors are uncommon diseases. During the surgery and due to the interposition of the facial nerve in the tumor approach, the facial nerve must be elevated from the fallopian canal and placed permanently into an anterior position. Although this maneuver provides a wide exposure, most of the patients suffer a long-term total or partial facial palsy. The purpose of this article is to check whether the infratemporal fossa approach without transposition of the facial nerve is equivalent to the approach with rerouting of the facial nerve regarding postsurgical morbidity. The clinical records of 52 patients who underwent an infratemporal fossa approach were reviewed in which 34 patients were segregated into two comparable groups regarding the presence or absence of transposition of the facial nerve. There were 19 women and 15 males. The majority of the patients (73 %) had jugular paragangliomas. The mean follow-up of the full series was 66 months. It was statistically significant that the worst facial nerve function at hospital discharge was in the patients who underwent facial nerve transposition (p = 0.001). Equally the facial nerve function in the no- rerouting group 1 year after the surgery was significantly much better than in the rerouting group (p = 0.003). Regarding to survival, recurrence or complications no significant differences were observed between both groups. Our study suggests that most of cases avoiding facial nerve transposition allow significant better functional results thereof without affecting other parameters such as recur- rence, complications or survival. Keywords Jugular fossa tumors Á Infratemporal fossa approach Á Facial nerve transposition Á Jugular paragangliomas Á Facial nerve rerouting Introduction Jugular fossa (JF) tumors and infralabyrinthine lesions are uncommon diseases, most of them of benign nature. Jug- ular paragangliomas (JPG) are by far the most frequent JF tumor. Lower cranial nerves (CN) schwannomas, JF meningiomas, infralabyrinthine cholesteatomas, metastatic tumors or chondrosarcomas are less frequent [1, 2]. Until the development of the infratemporal fossa approaches for the lateral skull base [3], the surgical treatment of these lesions was associated to an unacceptable rate of compli- cations and incomplete resections. The infratemporal fossa type A approach (IFTA) is focused on the JF and accepted as the standard technique for treating JF tumors. It allows an excellent control of the infralabyrinthine region as well as the middle ear and the neurovascular structures in the neck. Therefore, the IFTA is indicated in the management of JPG class C-2 and some J. L. Llorente (&) Á S. Obeso Á F. Lo ´pez Á A. Coca Á C. Sua ´rez ENT Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain e-mail: llorentependas@telefonica.net S. Obeso e-mail: sergioobeso@yahoo.es F. Lo ´pez e-mail: flopez_1981@yahoo.es A. Coca e-mail: acocapelaz@gmail.com C. Sua ´rez e-mail: csuarezn@seorl.net J. C. Rial Neurosurgery Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain e-mail: jcrial@yahoo.com 123 Eur Arch Otorhinolaryngol DOI 10.1007/s00405-013-2642-6