ANATOMIC STUDY OF LOCALIZATION OF FORAMEN OVALE, CAROTID CANAL, JUGULAR FORAMEN USING HENLE’S SPINE AS SURFACE LANDMARK IN SOUTH INDIAN ADULT SKULLS

There are 12 pairs of cranial nerves that are individually named and numbered using Roman numerals. Only some cranial nerves are mixed in function, i.e. they carry both sensory and motor fibres; others are purely sensory or motor and some may also carry pre- or post-ganglionic parasympathetic fibres. They pass through foramina in the base of the skull and are the olfactory (through cribriform plate to the nasal cavity), optic (through the optic foramen to the eye), oculomotor (through the cavernous sinus and superior orbital fissure to supply the eye), trochlear (as per oculomotor), trigeminal (three main branches that pass through the superior orbital fissure, foramen rotundum and foramen ovale, respectively), abducens (as per oculomotor), facial (through stylomastoid foramen to supply muscles of facial expression), vestibulocochlear (through the internal acoustic canal to control balance and hearing), glossopharyngeal, vagus, accessory (all pass through the jugular foramen) and hypoglossal (through the hypoglossal canal to control movements of the tongue) nerves.

Download Full-text

Anterior Facial Nerve Rerouting in Cranial Base Surgery: A Comparison of Three Techniques

Otolaryngology ◽

10.1016/s0194-5998(96)70141-9 ◽

1996 ◽

Vol 115 (1) ◽

pp. 82-88 ◽

Cited By ~ 13

Author(s):

Peter G. Von Doersten ◽

Robert K. Jackler

Keyword(s):

Facial Nerve ◽

Jugular Foramen ◽

Jugular Bulb ◽

Cranial Base ◽

Clinical Impression ◽

Canal Wall ◽

Posterior Aspect ◽

Pivot Point ◽

Carotid Canal ◽

Canal Wall Down

Anterior rerouting of the facial nerve is a maneuver designed to enhance exposure of the jugular foramen and carotid canal during resection of cranial base tumors. Our clinical impression is that the degree of additional exposure afforded by moving the facial nerve varies considerably according to both anatomic variations and the technique used. Three possible techniques exist based on the extent of facial nerve mobilization and point of rotation: canal wall up-second genu pivot point (CWU-2G); canal wall down-second genu pivot point (CWD-2G); and canal wall down-first genu pivot point (CWD-1G). We anatomically studied 20 human cadaver heads to establish clinically relevant guidelines for the selective use of these techniques. At the level of the dome of the jugular bulb, the facial nerve mobilized anteriorly a mean of 4.2 mm for CWU-2G, 10 mm for CWD-2G, and 14 mm for CWD-1G. Detailed analysis of numerous measurements and rotation angles suggests that the typical exposure afforded by the various rerouting techniques is as follows: CWU-2G, complete exposure of the jugular bulb; CWD-2G, exposure of the jugular bulb and a mean of 6 mm of the posterior aspect of the carotid artery; and CWD-1G, exposure of the jugular bulb and entire carotid genu. Minimizing the amount of facial nerve manipulation needed to achieve sufficient surgical exposure helps optimize postoperative functional status.

Download Full-text

Morphometric study of jugular foramen in adult South Indian skulls

Journal of Anatomical Society of India ◽

10.1016/j.jasi.2013.12.009 ◽

2013 ◽

Vol 62 (2) ◽

pp. 166-169

Author(s):

Sheetal Kotgirwar ◽

Sunita Athavale

Keyword(s):

Jugular Foramen ◽

Morphometric Study ◽

South Indian

Download Full-text

Microsurgical Resection of Glomus Jugulare Tumors With Facial Nerve Reconstruction: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opy100 ◽

2018 ◽

Vol 16 (1) ◽

pp. E1-E1 ◽

Cited By ~ 2

Author(s):

Duarte N C Cândido ◽

Jean Gonçalves de Oliveira ◽

Luis A B Borba

Keyword(s):

Facial Nerve ◽

Infratemporal Fossa ◽

Tumor Resection ◽

Cranial Nerves ◽

Jugular Foramen ◽

Jugular Bulb ◽

Senior Author ◽

Nerve Reconstruction ◽

Glomus Jugulare ◽

Carotid Canal

Abstract Paragangliomas are tumors originating from the paraganglionic system (autonomic nervous system), mostly found at the region around the jugular bulb, for which reason they are also termed glomus jugulare tumors (GJT). Although these lesions appear to be histologically benign, clinically they present with great morbidity, especially due to invasion of nearby structures such as the lower cranial nerves. These are challenging tumors, as they need complex approaches and great knowledge of the skull base. We present the case of a 31-year-old woman, operated by the senior author, with a 1-year history of tinnitus, vertigo, and progressive hearing loss, that evolved with facial nerve palsy (House-Brackmann IV) 2 months before surgery. Magnetic resonance imaging and computed tomography scans demonstrated a typical lesion with intense flow voids at the jugular foramen region with invasion of the petrous and tympanic bone, carotid canal, and middle ear, and extending to the infratemporal fossa (type C2 of Fisch's classification for GJT). During the procedure the mastoid part of the facial nerve was identified involved by tumor and needed to be resected. We also describe the technique for nerve reconstruction, using an interposition graft from the great auricular nerve, harvested at the beginning of the surgery. We achieved total tumor resection with a remarkable postoperative course. The patient also presented with facial function after 6 months. The patient consented with publication of her images.

Download Full-text

Trigeminal nerve haemangioma eroding the petrous carotid canal

The Journal of Laryngology & Otology ◽

10.1017/s0022215109004654 ◽

2009 ◽

Vol 123 (11) ◽

pp. 1258-1261 ◽

Cited By ~ 4

Author(s):

I Saliba ◽

F El Fata ◽

F Berthelet ◽

R Moumdjian

Keyword(s):

Trigeminal Nerve ◽

Soft Tissues ◽

Magnetic Resonance Imaging Scan ◽

Foramen Ovale ◽

Meckel’S Cave ◽

Rare Tumour ◽

Carotid Canal ◽

First Case ◽

Meckel's Cave ◽

The Right

AbstractObjective:To report the first case of mandibular branch haemangioma of the trigeminal nerve causing erosion of the petrous carotid canal. The radiological and histological findings in this case are reviewed.Case report:A 60-year-old woman presented with severe, right-sided facial pain and paraesthesia. There were no associated symptoms of facial weakness or diplopia. A magnetic resonance imaging scan with gadolinium enhancement was performed. This showed a lesion slightly compressing the right Meckel's cave and eroding the right petrous carotid canal, occupying the foramen ovale and extending to the pterygoid muscle. The lesion was removed via a subtemporal approach.Conclusion:Haemangiomas are usually found on the skin and in other soft tissues. However, this rare tumour should also be considered in the differential diagnosis of lesions occupying Meckel's cave and the foramen ovale.

Download Full-text

The transcondylar approach to the jugular foramen: A comparative anatomic study

Surgical Neurology ◽

10.1016/0090-3019(94)90275-5 ◽

1994 ◽

Vol 42 (3) ◽

pp. 265-271 ◽

Cited By ~ 14

Author(s):

Donald M. Seyfried ◽

Jack P. Rock

Keyword(s):

Jugular Foramen ◽

Anatomic Study ◽

Transcondylar Approach

Download Full-text

Osteological studies of skull base neurovascular area in reference to infratemporal approach to skull basec

IP Journal of Otorhinolaryngology and Allied Science ◽

10.18231/j.ijoas.2021.018 ◽

2021 ◽

Vol 4 (3) ◽

pp. 89-93

Author(s):

Harsh Sharma

Keyword(s):

Skull Base ◽

Cranial Nerves ◽

Relative Size ◽

Jugular Foramen ◽

Surgical Approaches ◽

Carotid Canal ◽

Stylomastoid Foramen ◽

Lateral Skull Base ◽

Infratemporal Approach ◽

Relationship Of

Surgical approaches to the lateral skull base often lead to tearing of vessels and piecemeal removal of the tumour. This study is aimed to delineate exact relationship of the various foramina at the lateral skull base. The coronal dimensions of the jugular foramina are larger as compared to sagittal with right sided dominance also noticed in the case of carotid canal. The width of “Keel” separating the carotid and jugular foramina normally varies from 0.4 to1.4 centimetres and may not always suggest the erosion of the foramen of skull base scans, unless the erosion is associated with irregularity or demineralization the thickness of this keel really depends upon relative size of the vessels and location of foramina. Area between stylomastoid foramen, carotid canal and jugular foramen is roughly wedge shaped. The angle subtended by carotid and jugular at the stylomastoid foramen is about 36.84whereas the location of stylomastoid foramen and internal carotid axis pose an angle of 83:16. The angle subtended by stylomastoid and jugular at carotid on an average 59:31. The space between these structures is measured to be 0.642centimetres which can be verified on tomograms. By using these measurements, the precise location of the upper end of the vessels could be predicted, whereas the superior stump could be clamped with minimal exposure of the skull base and identification and location of the last four cranial nerves is found out. This could avoid injuries and subsequent morbidity while carrying out surgery in this region.

Download Full-text