| The juxtacondylar approach to the jugular foramen. | |
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MedLine Citation:
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PMID: 18424969 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to describe the juxtacondylar approach to jugular foramen tumors. METHODS: Through an anterolateral approach, the third segment of the vertebral artery (between C2 and the dura mater) is controlled. The C1 transverse process of the atlas, which is located just inferiorly to the jugular foramen, is then removed. The dissection of the internal jugular vein is performed as high as possible, with control of the IXth, Xth, XIth, and XIIth cranial nerves. If required by a tumor extending into the neck, the internal and external carotid arteries can be exposed and controlled. Through a partial mastoidectomy and after removal of the bone covering the jugular tubercle, the end of the sigmoid sinus and then the posteroinferior part of the jugular foramen are reached. RESULTS: This technique is efficient to expose tumors extending into the jugular foramen. Contrary to the infratemporal approach, it has the main advantage of avoiding petrous bone drilling and associated potential complications. Lower cranial nerves are well exposed in the neck. In patients with schwannomas, complete resection with selective dividing of only the few involved rootlets can be achieved. CONCLUSION: The juxtacondylar approach is an efficient approach to tumors located in the jugular foramen. It necessitates control of the third segment of the vertebral artery but has the advantage of avoiding complications associated with petrous bone drilling. Extension beyond the jugular foramen requires combination with an infratemporal or a retrosigmoid approach. |
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Authors:
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Michaël Bruneau; Bernard George |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Neurosurgery Volume: 62 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-04-21 Completed Date: 2008-06-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 75-8; discussion 80-1 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Hôpital Lariboisière, Paris, France. mbruneau@ulb.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain Neoplasms
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surgery* Cranial Fossa, Posterior / surgery* Humans Jugular Veins / surgery* Neurosurgical Procedures / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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