Contrast Analysis And Microdissection Of The Exposure Of The Jugular Foramen Region Via Different Surgical Approaches

Objective To research the difference Of the extent and struction of the foramen jugulare region between far lateral inferior suboccipital approach and post aur presigmoid approach and improved post aur head and neck approach.Familiar with the area of the anatomical structure, to provide reliable evidence for clinical individuation selecting operative approach.totally resecting the tumor one time as far as possible and protecting of significant structures and functions.Methods Six adult cadaveric heads with10%formaldehyde solution were randomally assigned to three groups (grope A、B and C).There were two exemplars in every group.Simulated jugular foramen operative approach under high power microscope. The far lateral inferior suboccipital approach was applied to A,the post aur presigmoid approach was applied to B, the improved post aur head and neck approach was applied to C to proceed microdissection studies,exposed structure and scope were compared among above mentioned surgical approach.Result Far lateral inferior suboccipital approach was well for jugular foramen area intracranial structures exposed, Especially the foramen magnum area and the subjacent part of the brain stem front and side, post aur presigmoid approach was well for jugular foramen internal structure、tympanunm、mastoid air cell and cervical artery vagina peripheral structure exposed,but it was poorer for intracranial structure; improved post aur head and neck approach was well for extracranial-intracranial(EC-IC) structure through multi-angle such as rear,outside,above and below.Conclusion The exposure range and structure of jugular foramen area varies in different surgical approach. extracranial-intracranial was better multi-angle revealed by improved post aur head and neck approach, so as to achieve totally resecting the tumor.Therefore, It has very important meaning that different surgical approach should be selected and different bony landmark should be selected milled according to the lesions in the range of the jugular foramen,to effective exposed and exsect lesions.