Microsurgical anatomy of jugular foramen and clinical implications / 中华神经医学杂志

ABSTRACT

Objective To investigate the microsurgical anatomy of the jugular foramen and its adjacent structures so as to provide the anatomical base for the surgical approach and nerve preservation in the region. Methods With the aid of the surgical microscope, a combined approach was performed,which included transjugular approach, extreme lateral trans-condylar approach and infralabyrinthine approach. The jugular foramen and its adjacent structures were exposed from multi-directions step by step to identify the spatial relationships of important structures in this region. Results At the inner wall of skull, dural septations divided the jugular foramen into the petrosal portion, the sigmoid portion and the intrajugular compartment. The dura overlying the intrajugular compartment had two meatus, both of which were medial to the intrajugular processes. One was the glossopharyngeal meatus, and the other was the vagal meatus. The structures that traversed the jugular foramen were the sigmoid sinus, inferior petrosal sinus, jugular bulb, glossopharyngeus nervus, pneumogastric nerve, accessorius, meningeal branches of the ascending pharyngeal and occipital arteries, and the cochlear aqueduct. Conclusions It has more surgical significance to describe the petrosal, sigmoid, and intrajugular portions of the jugular foramen. The asterion can be defined as the landmark of the junction of transverse sinus and sigmoid sinus. Detailed micro-anatomic study may improve the success of surgery, protect cranial nerves and prevent unnecessary injury.