| Abstract: | The basic anatomy of the jugular foramen, some diagnostic principles of the jugular foramen tumors with presentation of our experiences of the 13 cases (6 neurinomas, 6 chemodectomas and 1 meningioma), and the detailed surgical technique used in their removal and its result are described. According to the extension of the tumor, one of the following operative approaches can be selected. A) Transjugular approach consists of a retromastoideal craniectomy following a radical mastoidectomy. The posterior wall of the jugular foramen is scraped out and the sigmoid sinus and the internal jugular vein are resected with the tumor either confined in the jugular foramen or extending out of the skull. B) Transjugular-transpetrosal approach is suitable for the tumor in the jugular foramen extending out of the skull as well as into the CP angle. The petrosal bone is more scraped out for removal of the tumor extending into the CP angle than in the above transjugular approach. In the case of the tumor extending into the CP angle and the upper clivus, the upper petrosal bone medial to the C-5-C-6 segments of the internal carotid artery are also removed and an extensive exposure of the intracranial tumor is obtained. C) A suboccipital craniectomy with retrolabyrinthine removal of the petrosal bone is suitable for large glosso-pharyngeal neurinomas extending into the CP angle but not out of the floor of the skull. In such cases, after removal of the CP angle tumor in the usual way, resection of the remaining jugular foramen tumor is easily performed through opening the petrosal bone forming the medial portion of the dome of the jugular fossa. |
