Most tumoral lesions of the jugular foramen manifest at ct as areas of infiltrative bone destruction. The lengths of the longest and widest axes of the jfs are measured as 21. Files are available under licenses specified on their description page. The computed tomographic et appearance of the jugular foramen was examined in detail, and anatomic and ct sections were correlated. Jugular foramen tumors are rare skull base lesions that present diagnostic and complex management problems. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations. Figure 3b shows the comparison of the same volumes collected from a second measurement. Eight were women and 4 were men mean age, 40 years, and the duration of their symptoms, the most predominant of which were hearing loss and tinnitus, ranged from 1 month to 20 years median, 8. The papilledema was explained by an increase in the intracranial pressure due to the rapid obstruction of venous drainage by the metastasis. Pdf the goal in paraganglioma resection is to allow adequate exposure to remove the lesion while preserving cranial nerve function.
The emphasis is on the various tumours that can be encountered. The objective of this article is to analyze the treatment and results in a series of ten cases. Foramen magnum, occipital condyles and hypoglossal canals. Morphometric evaluation of the jugular foramen at base of the skull in north indian population. Comparison of lateral microsurgical preauricular and anterior. The bony, neural, and vascular anatomy of the jugular foramen is described in the context of surgery for tumors that involve this region. No analysis of the shapes of the foramina was made except to note the occurrence of a pairfs septum between the occipital and petrous bones unilaterally in 17 method of measurement of size of jugular foramen, a width of pars nervosa.
Patent foramen ovale symptoms and causes mayo clinic. Nonpseudomonal malignant otitis externa and jugular. The jugular foramen jf transmits the internal jugular vein ijv, inferior petrosal sinus, meningeal branch of ascending pharyngeal artery, glossopharyngeal, vagus and spinal accessory nerves. Available formats pdf please select a format to send. Effectiveness of modified dural incision to preserve the. The vaginal process of the tympanic part of the temporal bone provides a valuable landmark to aid in accessing the jugular foramen in both procedures and can be. Jugular foramen definition of jugular foramen by medical. Complete morphometric analysis of jugular foramen and its. Primary meningiomas of the jugular foramen are extremely rare. Measurement of jugular foramen diameter using mri in multiple. Yasuhiko hayashi, issei fukui, yasuo sasagawa, kouichi misaki, masahiro oishi, mitsutoshi nakada. Conclusions jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. One hundred and fortyone 73 male and 68 female greek adult dry skulls were examined.
The jugular foramen is a large foramen opening in the base of the skull, located behind the carotid canal. The jugular foramen transmits the glossopharyngeal, vagus, and spinal accessory nerves. Chordomas located in the jugular foramen are extremely rare, with a low incidence of 0. From a series of 107 patients that had been operated on for jugular foramen tumors between 1987 and 2005, ten had meningiomas. There was marked emphysema with cyanosis of lips and nail beds. Intracranial pressure and the role of the vagus nerve. Graphical representation of the comparison of jugular foramen jf volumes in cavalier king charles spaniels with and without syringomyelia sm.
Meningiomas arising primarily in the jugular foramen appear to behave differently from meningiomas that involve the jugular foramen secondarily 1, 3, 4. No data were also available regarding the sexual differences of jugular foramen. Above the jugular foramen is the internal auditory meatus for the vestibulocochlear, and facial nerves. Mri revealed a persisting thrombus in the left jugular vein. A variety of lesions may occur in the jugular foramen, arising from the structures normally found within the jugular foramen or from contiguous structures. The carotid canal ends here at the foramen lacerum, as well see in the next section. The human skull has numerous openings, through which cranial nerves, arteries, veins, and other structures pass.
The jugular foramen shows a canallike structure with an external and an internal opening. During fetal development, a small flaplike opening the foramen ovale fohraymun ohvaylee is normally present in the wall between the right and left upper chambers of the heart atria. The jugular foramen is usually described as being divided into two parts by a fibrous or bony septum, called the jugular spine, into. Accessory nerve schwannoma extending to the foramen. A 64yearold male with 20 years of dizziness history complaining of 6 months of. Intrareader and interreader reproducibility were 91% and 88%, respectively. Key words jugular foramen jugular fossa skull base variation vernets syndrome eissn 84038 slitlike jugular foramen due to abnormal bone growth at jugular fossa and 9. Aclands dvd atlas of human anatomy transcript for volume. This is a pdf file of the manuscript that has been.
Anatomic and computed tomographic study the computed tomographic et appearance of the jugular foramen was examined in detail, and anatomic and ct sections were correlated. Surgical approaches to jugular foramen schwannomas. There have been no previous reports of a small, accessory neurinoma that is confined entirely to the jugular foramen, appearing with a typical jugular foramen syndrome. This approach was used in seven patients, eliminates the need for facial nerve transposition, and helps to preserve cochleovestibular function. Primary jugular foramen meningioma is a common tumor in an unusual location 1, 2. The jugular foramen is located posterior to the carotid canal and is formed anteriorly by the petrous portion of the temporal bone and posteriorly by the occipital bone 2. Secondary jugular foramen meningiomas were excluded from this study. In the lateral part of the occipital bone, extending lateralward from the posterior half of the condyle is a quadrilateral or triangular plate of bone, the jugular process, excavated in front by the jugular notch, which, in the articulated skull, forms the posterior part of the jugular foramen. Various morphometric data of jugular foramen on indian population are available, but they were done from the exocranial aspect of skull base only,3,8,9,10,11,12, which is not a complete morphometry of jugular foramen. In our experience, symmetrical bilateral projections combined with tomography represent a useful compromise.
A transsigmoid approach is detailed for removal of tumors involving the jugular foramen. A 43 years old male patient presented clinically with tinnitus in the right ear with bulbar, facial and trigeminal nerve dysfunction. Imaging of jugular foramen jugular foramen, albeit complex, is essentially a bony conduit transmitting nerves and vessels from the posterior cranial fossa to the nasopharyngeal carotid space. The purpose of this study was to assess how well the anatomy of the jugular foramen jf could be displayed by 3t mr imaging by using a 3d contrastenhanced fast. Because without knowing these foramen, it would not be possible to learn the structures that passes through them. Labs 9 bone physiology and anatomy and skeletal system.
Transsigmoid approach for tumors of the jugular foramen. Jun 12, 20 this chapter discusses the jugular fossa with a description of the anatomy, a discussion of the radiological imaging techniques. Apr 15, 2017 before going into detail of each of the foramen of skull, first have a look at the names of these foramen and learn their names. While 40% give evidence of intracranial extension,6 the majority invade the middle ear by erosion through the floor of the hypotympanumand presentgrosslyas vascu lar polypoidtissue in the middle ear. It contains the lower cranial nerves and major vascular structures.
If the inline pdf is not rendering correctly, you can download the pdf file here. Cerebrospinal fluid csf leakage is one of the most common complications of this surgery. Jugular foramen may be classified into three parts petrosal, sigmoid and intrajugular part according to the structures which passed through the jugular foramen. Jugular foramen syndrome can be caused by multiple etiologies, with various lesions affecting the foramen table 1 1. Nov 12, 2010 this licensing tag was added to this file as part of the gfdl licensing update.
Far lateral approach and jugular foramen part 1 of 2 youtube. Jugular foramen article about jugular foramen by the free. Primary jugular foramen meningiomas are characterized by extensive skull base infiltration, which results in important clinical, surgical, and imaging. The foramens irregular shape, its formation by two bones and the numerous nerves and venous channels that pass through it further compound its anatomy.
Surgical anatomy of the jugular foramen springerlink. A patent foramen ovale pfo is a hole in the heart that didnt close the way it should after birth. The muscles of the left side of his neck were atrophied, and his left shoulder sagged. Lewis 1891 an elementary latin dictionary, new york. Names of foramen of skull and structures passing via them. Jugular foramen definition of jugular foramen by the free. After that you would be able to learn the structures that passes through them. One year later, the patient had residual hoarseness and choking on water. Surgical treatment of jugular foramen schwannomas nowak. Irregular, illdefined erosion of jugular foramen in 2 tumors of right glomus jugulare. Richard1,2, zhi gang lan1, yuekang zhang1, chao you1 1department of neurosurgery, post graduate training centre, west china hospital, sichuan university, chengdu, china.
This is a pdf file of the manuscript that has been accepted for publication. The jugular foramen is a large aperture in the skull base. Reconstruction of the cranial base in surgery for jugular. Pdf measurement of jugular foramen diameter using mri in. The jugular foramen jf varies in shape and size from side to side in the same cranium, and in different crania, racial groups and sexes. Oct 26, 2011 carefully crafted over many years by internationally renowned surgeon and educator dr. The jugular fossa is a depression situated on the inferior surface of petrous temporal bone posterior to the inferior opening of carotid canal. Quizlet flashcards, activities and games help you improve your grades. Current study examines morphometric alterations of the foramen magnum fm, occipital condyles ocs and hypoglossal canals hcs and highlights all the morphometric parameters of the fm area that present side asymmetry, gender dimorphism and are affected by the ageing.
Abstractclosure of the sigmoidjugular complex is generally planned during various surgical. You may do so in any reasonable manner, but not in. A case of vernet syndrome associated with internal jugular. Jun 29, 2017 there was no significant correlation between foramen diameters and the expanded disability status scale p. We defined it as primary when it was centered in the jugular foramen and secondary when it was centered in the posterior fossa with secondary extension into the jugular foramen. Anatomy, head and neck, jugular foramen statpearls ncbi. There is controversy regarding the management of these tumors. Read surgical approaches to jugular foramen schwannomas.
Full text full text is available as a scanned copy of the original print version. Tumors along extraaxial locations in the head and neck are rare. The jugular foramen a morphometric study idowu folia. The surgical management of temporal bone cholesteatoma. Permission is granted to copy, distribute andor modify this document under the terms of the gnu free documentation license, version 1. Through this skull aperture also pass the transverse sinus, the inferior petrosal sinus, and meningeal branches from both the occipital and ascending pharyngeal arteries. All structured data from the file and property namespaces is available under the creative commons cc0 license. Choose the one alternative that best completes the statement or answers the question.
The jugular foramen courses anteriorly, laterally, and inferiorly as it insinuates itself between the petrous temporal bone and the occipital bone. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower cn deficits. The lesion was visualized only on magnetic resonance imaging, and surgery confirmed that it originated from a cranial root of the accessory nerve. Pdf intradural jugular foramen tumors researchgate. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. N2 the complexity of the jugular foramen can be appreciated once its deep location, variability in shape and size, and neurovascular contents are recognized.
Firefox file edit view history bookmarks tools window help stop re cording ck search. Conclusions jugular foramen diameter in patients with ms was 710% smaller than that in controls, regardless of the ms disease course. An approach to the evaluation of the patient with pulsatile tinnitus with emphasis on the anatomy and pathology of the jugular foramen author links open overlay panel joel d. In addition to its intrinsic pathologic conditions, a variety of lesions can arise from the contiguous surrounding structures and invade the foramen. Accessory nerve neurinoma manifesting with typical jugular. Syndrome of the jugular foramen pubmed central pmc. Imaging of jugular foramen antibodies or varicella zoster dna in the cerebrospinal fluid. Twelve patients with jugular foramen neurinoma were operated on at our clinic between 1974 and 1990. Vernets syndrome, a deficit of cranial nerves ix, x and xi, also called jugular foramen syndrome, was first reported by vernet in 1918. The surgical management of temporal bone cholesteatoma involving into jugular foramen volume supplement chunfu dai. Full text get a printable copy pdf file of the complete article 2. Involvement of the jugular foramen causes a lower cranial nerve deficit. Papilledema in the metastatic jugular foramen syndrome. The surgical removal of a jugular foramen jf tumor presents the neurosurgeon with a complex management problem that requires an understanding of the natural history, diagnosis, surgical approaches, and postoperative complications.
Tumors that develop within it, or extend into it, provide significant diagnostic. The jugular foramen jf is a canal that makes communication between the posterior cranial fossa and the upper neck for one third of the cranial nerves and for. The jugular foramen jf, sometimes referred to as the posterior foramen lacerum, is situated in the floor of the posterior fossa posterolateral to the carotid canal, between the petrous temporal bone anterolaterally and the occipital bone posteromedially fig. Volume reduction of the jugular foramina in cavalier king. Effectiveness of modified dural incision to preserve the patency of the occipital sinus in foramen magnum decompression for a patient with chiari malformation type i. Another foramen which is completely separated by a spicule of bone and which transmits the inferior petrosal sinus was present in 5. An osteometric evaluation of the jugular foramen an osteometric evaluation of the jugular foramen. Structural variations in the jugular foramen of the human.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Jugular foramen diameter in patients with ms was 710% smaller than that in controls, regardless of the ms disease course. The hypoglossal nerve does not traverse the jugular foramen. Figure 3a presents differences in the volume of the left jf between ckcss with and without sm. Foramen definition of foramen by medical dictionary. Nonpseudomonal malignant otitis externa and jugular foramen syndrome secondary to cyclosporininduced hypertrichosis in a diabetic renal transplant patient volume 114 issue 5 j.
The purpose of this study was to evaluate a series of patients with jugular foramen tumors who were surgically treated in the past 16 years, and to analyze the surgical technique, complications, and outcomes. Jugular veins left brachiocephalic right subclavian vein right brachiocephalic vein superior vena cava. There is a separate paragraph on lesions of the jugular foramen in children. The anterior endoscopic approach to the anterolateral part of the jugular foramen is a useful alternative to the lateral microsurgical preauricular approach in carefully selected cases. Slitlike jugular foramen due to abnormal bone growth at. Pdf anatomy involved in the jugular foramen approach for. The base of the skull has multiple important foramina that allow the passing of vital tissues primarily blood vessels and nerves. In addition to a number of anatomic variants and imaging artifacts, it may be affected by a variety of primary and secondary lesions. This article is from acta otorhinolaryngologica italica, volume 34. Chordomas are rare malignant neoplasms arised from residual embryonic notochordal tissue, mostly located in the axial midline. It is located behind the carotid canal and is formed in front by the petrous bone, and behind by the occipital bone. Through other openings, the jugular foramina, pass the large blood channels called the sigmoid sinuses and also the 9th glossopharyngeal, 10th vagus, and 11th spinal accessory cranial nerves as they leave the cranial cavity. The aim of this study is to describe the presenting symptoms, radiographic findings, operative procedures, and postoperative outcome of five histologically confirmed cases of chondrosarcomas arising from the jugular foramen.
The most common jugular foramen lesions are nontumoral pseudolesions eg, asymmetrically enlarged jugular foramen, high or protruding jugular bulb and tumors eg, paraganglioma, metastasis. This file is licensed under the creative commons attributionshare alike 3. It is formed in front by the petrous portion of the temporal bone, and behind by the occipital bone. The jugular foramen courses anteriorly, laterally, and inferiorly as it insinuates itself between the petrous temporal bone and the occipital bone gross anatomy. The jugular foramen is a complex crossroad of neurovascular structures in the skull base. Pdf differential diagnosis of jugular foramen lesions. Pronunciation of jugular foramen with 1 audio pronunciation and more for jugular foramen. There may be a difference in sides regarding the jugular foramen and number of arachnoid granulations, as there are side. Anatomical variation in the course of the nerves and vessels adds to the complexity of this area.
The jugular foramen jf is a canal that makes communication between the posterior cranial fossa and the upper neck for one third of the cranial nerves. Get a printable copy pdf file of the complete article 9k, or click on a page image below to browse page by page. Although the endoscopic endonasal approach to the jugular foramen has gained academic interest in recent years, the surgical practicality and ethics of such an approach to lesions of the extracranial aspect of the jugular foramen. Twelve cases of schwannomas of the jugular foramen that involved surgery in our department between 1983 and 1997 are described. Pdf comparative morphometric study of the sigmoid sinus. These cells have a welldefined chemoreceptor function 16. The tympanic branches of 9th and 10th cranial nerves also pass through jugular foramen.
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