Anatomical study of a surgical approach through the neck to the jugular foramen under endoscopy
- PDF / 2,260,883 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 161 Views
ORIGINAL ARTICLE
Anatomical study of a surgical approach through the neck to the jugular foramen under endoscopy Peng Fei Lai1 · Xiao Wu1 · Shi Hai Lan1 · Bin Tang1 · Hui Yan Huang1 · Tao Hong1 Received: 28 March 2020 / Accepted: 12 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Objectives To investigate the feasibility of an endoscopic surgical approach through the neck to the jugular foramen, to determine the relevant techniques and extent of exposure, and to provide a new surgical approach with minimal trauma. Methods Nine cadaveric head specimens with attached necks were fixed with 10% formalin solution. Two of the heads were fixed and injected with colored silicone rubber. Through the dissection of these cadaver head and neck specimens, we designed a surgical approach from the neck to the jugular foramen area with the use of a neuroendoscope and performed simulated surgery to determine which anatomical structures were encountered in the approach. Results The posterior aspect of the internal jugular vein is adjacent to the rectus capitis lateralis. The internal carotid artery is anteromedial to the internal jugular vein, with the glossopharyngeal nerve, accessory nerve, vagus nerve and hypoglossal nerve in between. Removal of the rectus capitis lateralis can reveal the jugular process, and exposing the space between the superior oblique muscle and the jugular process can reveal the atlanto-occipital joint. Drilling through the occipital condyle can facilitate entrance into the skull, expose the flank of the medulla oblongata, and reveal the medullary olive and accessory nerve, vagus nerve, hypoglossal nerve, vertebral artery and posterior inferior cerebellar artery. Removing the jugular vein and completely opening the posterior wall of the jugular foramen can expose the inferior wall of the jugular bulb and the inferior wall of the sigmoid sinus. Drilling through the styloid process, which is lateral to the internal jugular vein, can expose the lateral area and upper wall of the jugular bulb and cranial nerves (CN) IX–XII; and near the top of the jugular bulb, the tympanic cavity and the external auditory canal can be easily opened. Conclusion Endoscopic surgical access from the neck to the jugular foramen is feasible. This surgical approach can simultaneously remove intracranial and extracranial tumors and can also be used to remove tumors in the ventral region of the occipital foramen and the hypoglossal canal. Furthermore, this approach is advantageous in that minimal trauma is inflicted. With judicious patient selection, this approach may have significant advantages and may be used as a primary or secondary surgical approach in the future. Nonetheless, this approach is still in development in a laboratory setting, and further research and improvements are needed before facing more complicated situations in clinical practice. Keywords Jugular foramen · Surgical approach · Endoscopy · Anatomical study
Introduction
Peng Fei Lai and Xiao Wu, Shi Hai Lan contributed
Data Loading...
