Microsurgical Anatomy of and Surgical Approaches to the Jugular Foramen

2014 ◽  
pp. 277-297
Author(s):  
Toshio Matsushima
Keyword(s):  
Jugular Foramen ◽  
Surgical Approaches ◽  
Microsurgical Anatomy

Microsurgical Anatomy of the Jugular Process as an Anatomical Landmark to Access the Jugular Foramen: A Cadaveric and Radiological Study

2018 ◽  
Vol 16 (4) ◽  
pp. 486-495 ◽  
Author(s):  
Noritaka Komune ◽  
Satoshi Matsuo ◽  
Koichi Miki ◽  
Ken Matsushima ◽  
Yojiro Akagi ◽  
...  
Keyword(s):  
Jugular Foramen ◽  
Jugular Bulb ◽  
Morphological Features ◽  
Cadaveric Study ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Close Relationship ◽  
Superior Surface ◽  
Posterior Condylar ◽  
The Right

Abstract BACKGROUND The jugular process forms the posteroinferior surface of the jugular foramen and is an important structure for surgical approaches to the foramen. However, its morphological features have not been well described in modern texts. OBJECTIVE To elucidate the microsurgical anatomy of the jugular process and examine its morphological features. METHODS Five adult cadaveric specimens were dissected in a cadaveric study, and computed tomography data from 31 heads (62 sides) were examined using OsiriX (Pixmeo SARL, Bernex, Switzerland) to elucidate the morphological features of the jugular process. RESULTS The cadaveric study showed that it has a close relationship with the sigmoid sinus, jugular bulb, rectus capitis lateralis, lateral atlanto-occipital ligament, and lateral and posterior condylar veins. The radiographic study showed that 9/62 sigmoid sinuses protruded inferiorly into the jugular process and that in 5/62 sides, this process was pneumatized. At the entry of the jugular foramen, if the temporal bone has a bulb-type jugular bulb, and if surgery concerns the right side of the head, the superior surface of the jugular process is more likely to be steep. CONCLUSION The jugular process forms the posteroinferior border of the jugular foramen. Resection of the jugular process is a critical step for opening the jugular foramen from the posterior and lateral aspects. Understanding the morphological features of the jugular process, and preoperative and radiographical examination of this process thus help skull base surgeons to access the jugular foramen.

Revising the Indications of Transtemporal Surgical Approaches in the Modern Endoscopic Era of Skull Base Surgery: A Dying Art

2020 ◽  
Author(s):  
Ravi Sankar Manogaran ◽  
Raj Kumar ◽  
Arulalan Mathialagan ◽  
Anant Mehrotra ◽  
Amit Keshri ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Approach ◽  
Nerve Palsy ◽  
Tertiary Care ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Complete Excision ◽  
Lateral Skull Base ◽  
The Individual ◽  
Selection Of

Abstract Objectives The aim of the study is to emphasize and explore the possible transtemporal approaches for spectrum of complicated lateral skull base pathologies. Design Retrospective analysis of complicated lateral skull base pathologies was managed in our institute between January 2017 and December 2019. Setting The study was conducted in a tertiary care referral center. Main Outcome Measures The study focused on the selection of approach based on site and extent of the pathology, the surgical nuances for each approach, and the associated complications. Results A total of 10 different pathologies of the lateral skull base were managed by different transtemporal approaches. The most common complication encountered was facial nerve palsy (43%, n = 6). Other complications included cerebrospinal fluid (CSF) collection (15%, n = 2), cosmetic deformity (24%, n = 4), petrous internal carotid artery injury (7%, n = 1), and hypoglossal nerve palsy (7%, n = 1). The cosmetic deformity included flap necrosis (n = 2) and postoperative bony defects leading to contour defects of the scalp (n = 2). Conclusion Surgical approach should be tailored based on the individual basis, to obtain adequate exposure and complete excision. Selection of appropriate surgical approach should also be based on the training and preference of the operating surgeon. Whenever necessary, combined surgical approaches facilitating full tumor exposure are recommended so that complete tumor excision is feasible. This requires a multidisciplinary team comprising neurosurgeons, neuro-otologist, neuroanesthetist, and plastic surgeons. The surgeon must know precise microsurgical anatomy to preserve the adjacent nerves and vessels, which is necessary for better surgical outcomes.

scholarly journals Jugular Foramen Schwannomas: Surgical Approaches and Outcome of Treatment

Skull Base ◽  
1999 ◽  
Vol 9 (04) ◽  
pp. 243-252 ◽  
Author(s):  
Heon Yoo ◽  
Hee-Won Jung ◽  
Hee Jin Yang
Keyword(s):  
Jugular Foramen ◽  
Surgical Approaches

scholarly journals Anatomy of the Orbit

2020 ◽  
Vol 81 (04) ◽  
pp. 319-332
Author(s):  
Stefan Lieber ◽  
Juan C. Fernandez-Miranda
Keyword(s):  
Anterior Part ◽  
Cranial Base ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Orbital Apex ◽  
Special Issue ◽  
Superior Orbital Fissure ◽  
Anatomical Structures ◽  
Transnasal Surgery ◽  
Maxillary Sinuses

AbstractThe orbit is a paired, transversely oval, and cone-shaped osseous cavity bounded and formed by the anterior and middle cranial base as well as the viscerocranium. Its main contents are the anterior part of the visual system, globe and optic nerve, and the associated neural, vascular, muscular, glandular, and ligamentous structures required for oculomotion, lacrimation, accommodation, and sensation.A complex stream of afferent and efferent information passes through the orbit, which necessitates a direct communication with the anterior and middle cranial fossae, the pterygopalatine and infratemporal fossae, as well as the aerated adjacent frontal, sphenoidal, and maxillary sinuses and the nasal cavity.This article provides a detailed illustration and description of the microsurgical anatomy of the orbit, with a focus on the intrinsically complex spatial relationships around the annular tendon and the superior orbital fissure, the transition from cavernous sinus to the orbital apex. Sparse reference will be made to surgical approaches, their indications or limitations, since they are addressed elsewhere in this special issue. Instead, an attempt has been made to highlight anatomical structures and elucidate concepts most relevant to safe and effective transcranial, transfacial, transorbital, or transnasal surgery of orbital, periorbital, and skull base pathologies.

Microsurgical Anatomy and Surgical Approaches of the Cranial Base: The Radial Corridors

2020 ◽  
pp. 583-615
Author(s):  
Alejandro Monroy-Sosa ◽  
Srikant S. Chakravarthi ◽  
Austin Epping ◽  
Melanie B. Fukui ◽  
Richard A. Rovin ◽  
...  
Keyword(s):  
Cranial Base ◽  
Surgical Approaches ◽  
Microsurgical Anatomy

scholarly journals The microsurgical anatomy of the glossopharyngeal nerve with respect to the jugular foramen lesions

2004 ◽  
Vol 17 (2) ◽  
pp. 12-21 ◽  
Author(s):  
Mehmet Faik Özveren ◽  
Uđur Türe
Keyword(s):  
Surgical Treatment ◽  
Cranial Nerves ◽  
Jugular Foramen ◽  
Glossopharyngeal Nerve ◽  
Detailed Knowledge ◽  
Microsurgical Anatomy ◽  
Anatomical Landmarks ◽  
Related Area ◽  
Deep Layers ◽  
Lower Cranial Nerves

Removal of lesions involving the jugular foramen region requires detailed knowledge of the anatomy and anatomical landmarks of the related area, especially the lower cranial nerves. The glossopharyngeal nerve courses along the uppermost part of the jugular foramen and is well hidden in the deep layers of the neck, making this nerve is the most difficult one to identify during surgery. It may be involved in various pathological entities along its course. The glossopharyngeal nerve can also be compromised iatrogenically during the surgical treatment of such lesions. The authors define landmarks that can help identify this nerve during surgery and discuss the types of lesions that may involve each portion of the glossopharyngeal nerve.

scholarly journals Microsurgical Anatomy of the Jugular Foramen Applied to Surgery of Glomus Jugulare via Craniocervical Approach

2020 ◽  
Vol 7 ◽  
Author(s):  
Felipe Constanzo ◽  
Mauricio Coelho Neto ◽  
Gustavo Fabiano Nogueira ◽  
Ricardo Ramina
Keyword(s):  
Jugular Foramen ◽  
Microsurgical Anatomy ◽  
Glomus Jugulare

scholarly journals Microsurgical anatomy and approaches around the lateral recess with special reference to entry into the pons

2018 ◽  
Vol 129 (3) ◽  
pp. 740-751 ◽  
Author(s):  
Osamu Akiyama ◽  
Ken Matsushima ◽  
Maximiliano Nunez ◽  
Satoshi Matsuo ◽  
Akihide Kondo ◽  
...  
Keyword(s):  
Surgical Approaches ◽  
Morphometric Study ◽  
Microsurgical Anatomy ◽  
Entry Zone ◽  
Lateral Recess ◽  
Fiber Tracts ◽  
Adjacent Structures ◽  
Microsurgical Techniques ◽  
Safe Entry Zone ◽  
Wide Exposure

OBJECTIVEThe lateral recess is a unique structure communicating between the ventricle and cistern, which is exposed when treating lesions involving the fourth ventricle and the brainstem with surgical approaches such as the transcerebellomedullary fissure approach. In this study, the authors examined the microsurgical anatomy around the lateral recess, including the fiber tracts, and analyzed their findings with respect to surgical exposure of the lateral recess and entry into the lower pons.METHODSTen cadaveric heads were examined with microsurgical techniques, and 2 heads were examined with fiber dissection to clarify the anatomy between the lateral recess and adjacent structures. The lateral and medial routes directed to the lateral recess in the transcerebellomedullary fissure approach were demonstrated. A morphometric study was conducted in the 10 cadaveric heads (20 sides).RESULTSThe lateral recess was classified into medullary and cisternal segments. The medial and lateral routes in the transcerebellomedullary fissure approach provided access to approximately 140º–150º of the posteroinferior circumference of the lateral recess. The floccular peduncle ran rostral to the lateral recess, and this region was considered to be a potential safe entry zone to the lower pons. By appropriately selecting either route, medial-to-lateral or lateral-to-medial entry axis is possible, and combining both routes provided wide exposure of the lower pons around the lateral recess.CONCLUSIONSThe medial and lateral routes of the transcerebellomedullary fissure approach provided wide exposure of the lateral recess, and incision around the floccular peduncle is a potential new safe entry zone to the lower pons.

The microsurgical anatomy of the jugular foramen as seen in the zygomatic and infratemporal fossa approaches

1997 ◽  
Vol 99 ◽  
pp. S144
Author(s):  
Luis A.B. Borba ◽  
Ossama Al-Mefty ◽  
Luis F.P. Franco ◽  
Fernando M. Braga
Keyword(s):  
Infratemporal Fossa ◽  
Jugular Foramen ◽  
Microsurgical Anatomy
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