Surgical treatment of dumbbell-shaped jugular foramen schwannomas via two-piece lateral suboccipital approach: Report of 26 patients

2021 ◽  
Vol 94 ◽  
pp. 32-37
Author(s):  
Xu Wang ◽  
Jiantao Liang ◽  
Mingchu Li ◽  
Jie Bai ◽  
Jie Tang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Jugular Foramen ◽  
Lateral Suboccipital Approach ◽  
Suboccipital Approach

Surgical Approaches to Aneurysms of the Vertebral and Basilar Arteries

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Robert A. Solomon ◽  
Bennett M. Stein
Keyword(s):  
Surgical Treatment ◽  
Life Style ◽  
Petrous Apex ◽  
Surgical Approaches ◽  
Lateral Sinus ◽  
Basilar Arteries ◽  
Lateral Suboccipital Approach ◽  
Suboccipital Approach ◽  
Supratentorial Approach ◽  
Selection Of

ABSTRACT This report details the surgical treatment of 44 patients with aneurysms of the vertebral and basilar arteries. Three different surgical approaches were utilized depending on the location of the aneurysm. These were an anterior supratentorial approach, a lateral suboccipital approach, and a combined supratentorial and infratentorial approach along the petrous apex, with section of the lateral sinus and the tentorium. Using these operative exposures, aneurysms located anywhere on the vertebral-basilar arteries may be safely visualized and clipped. In this series, 1 patient died, 4 other patients had significant, long-lasting morbidity as a result of operation, and 32 patients returned to work and a normal life-style. These data support operative intervention under proper conditions and with selection of the correct exposures for the treatment of vertebral-basilar aneurysms.

scholarly journals Lateral Suboccipital Approach in Semisitting Position for Resection of Vagal Schwannoma: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Stefan Lieber ◽  
Maximiliano Nunez ◽  
Marcos Tatagiba
Keyword(s):  
Jugular Foramen ◽  
Progressive Multiple Sclerosis ◽  
Proliferation Index ◽  
Gag Reflex ◽  
Lateral Suboccipital Approach ◽  
Cranial Fossa ◽  
Set Up ◽  
The Right ◽  
Suboccipital Approach

AbstractWe present a case of a sizeable vagal schwannoma that was resected through a lateral suboccipital approach in semisitting position. An extra-axial lesion, occupying the left cerebellomedullary cistern and extending from the pontomedullary junction to the jugular foramen was incidentally discovered in a 40-year-old woman afflicted with secondary progressive multiple sclerosis during repeated magnetic resonance imaging (Fig. 1). On physical examination, a mild deviation of the uvula to the right and a diminished gag reflex were observed. The patient was referred to our department after considerable growth of the lesion was noted and a broad interdisciplinary consensus was reached to treat the lesion surgically.A gross total resection was achieved, histopathology confirmed a WHO I schwannoma with a low proliferation index. Postoperative dysphonia resolved completely within a few weeks, there was no collateral neurological deficit and especially no functional dysphagia. At 3-year follow-up, there was no indication of residual or recurrence.This 2-dimensional video demonstrates pre- and postoperative imaging, positioning and set-up of operating room, anatomical and surgical nuances of the skull base approach, and the operative technique for microdissection of the schwannoma from the critical neurovascular structures (Fig. 2).In summary, the lateral suboccipital approach in semisitting position is a powerful tool in the armamentarium for the microsurgical management of various pathologies residing in the posterior cranial fossa, especially large and vascularized schwannomas. Provided the necessary anesthesiological precautions and intraoperative procedures the semisitting position is safe and effective.The link to the video can be found at: https://youtu.be/-9o_qJGkQhg.

Three-Dimensional Computed Tomography Angiography Assisted Resection of Ventral Foramen Magnum and Jugular Foramen Tumours via Modified Far Lateral Suboccipital Approach

2019 ◽  
Vol 9 (2) ◽  
pp. 354-359
Author(s):  
Dongxue Li ◽  
Xuefei Deng ◽  
Shiying Ling ◽  
Nan Zhang ◽  
Dejun Bao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Facial Paralysis ◽  
Computed Tomography Angiography ◽  
Three Dimensional ◽  
Jugular Foramen ◽  
Foramen Magnum ◽  
Lateral Suboccipital Approach ◽  
Far Lateral ◽  
Suboccipital Approach

Objective: The anatomical relationship of ventral foramen magnum and jugular foramen tumour is complex and the operation is very difficult. The aim of this study was to summarize the microsurgical experience of the removal of the ventral foramen magnum and jugular foramen tumours via the modified far lateral suboccipital approach assisted by three-dimensional computed tomography angiography (3D-CTA). Methods: The clinical data and follow-up results of 13 cases of 3D-CTA assisted suboccipital far lateral approach from July 2011 to September 2017 were analyzed retrospectively. There were 5 males and 8 females. Preoperative CT and MRI were used for routine imaging diagnosis, and the 3D-CTA simulated surgical approach was performed. The preoperative operation scheme was established, and the risk of operation was evaluated according simulated operation. After individualized exposure, the modified far lateral suboccipital approach was completed under the neuroelectrophysiological monitoring technique. Results: The preoperative images were completely consistent with the findings in the surgery. There were 9 cases of jugular foramen tumour and 4 cases of ventral foramen magnum tumour. Of the 13 cases, only 1 case of jugular glomus tumour had extra-cranial residual, while the whole intracranial tumour was removed. In other 12 cases, the tumours were completely removed under the microscope. After operation, the headache disappeared, and hearing loss was improved. There was no perioperative deaths, infection and cerebrospinal fluid leakage. The facial paralysis was occurred in 1 patient. After 3–39 months of follow-up, there was no recurrence of tumour, or new nerve function defect. Hoarseness, choking of drinking water and numbness of limbs were all improved at the end of the follow-up period. The symptoms of postoperative facial paralysis were also improved during the follow-up period. Conclusion: After the preoperative simulation and evaluation by 3D-CTA, the ventral foramen magnum and jugular foramen tumours can be rescted safely and effectively via far modified lateral suboccipital approach.

Surgical Treatment of the Tumors of the Jugular Foramen

2020 ◽  
pp. 909-931
Author(s):  
Duarte Nuno Crispim Cândido ◽  
Luis A. B. Borba
Keyword(s):  
Surgical Treatment ◽  
Jugular Foramen

History, Variations, and Extensions of the Retrosigmoid Approach: Anatomical and Literature Review

2021 ◽  
Author(s):  
Jaafar Basma ◽  
Christos Anagnostopoulos ◽  
Andrei Tudose ◽  
Mikhail Harty ◽  
L. Madison Michael ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Jugular Foramen ◽  
Retrosigmoid Approach ◽  
Anatomical Landmarks ◽  
Posterior Fossa Surgery ◽  
Different Types ◽  
Microsurgical Techniques ◽  
Subarachnoid Spaces ◽  
Far Lateral ◽  
Suboccipital Approach

AbstractThe retrosigmoid approach is the workhorse for posterior fossa surgery. It gives a versatile corridor to tackle different types of lesions in and around the cerebellopontine angle. The term “extended” has been used interchangeably in the literature, sometimes creating confusion. Our aim was to present a thorough analysis of the approach, its history, and its potential extensions. Releasing cerebrospinal fluid from the subarachnoid spaces and meticulous microsurgical techniques allowed for the emergence of the retrosigmoid approach as a unilateral variation of the traditional suboccipital approach. Anatomical landmarks are helpful in localizing the venous sinuses and planning the craniotomy, and Rhoton's rule of three is the key to unlock difficult neurovascular relationships. Extensions of the approach include, among others, the transmastoid, supracerebellar, far-lateral, jugular foramen, and perimeatal approaches. The retrosigmoid approach applies to a broad range of pathologies and, with its extensions, can provide adequate exposure, obviating the need for extensive and complicated approaches.

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.

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