The Applied Anatomy Of The Jugular Foramen Region Communicating Tumors

Part?the measurements between the important bony structures around Jugular foramenObjective To observe the important bony structure around the jugular foramen region and anatomic relationship between the important structures,To measure the distances of the intracranial and extracranial important structures respectively,To provide the anatomical basis for dealing with jugular foramen region communicating tumors.Methods To observe the important bony structure around the jugular foramen region from the intracranial and extracranial sides,To further measure the distances of the intracranial and extracranial important structures respectively in 22 dry adult skull specimens.Results The inside of the skull:(1)The internal auditory pore is situated anterior superior to the jugular foramen 5.40(3.92~6.64)mm(2)The fissure for endolymphatic sac is situated superior to the jugular foramen 12.98(8.26~16.78)mm(3)The fissure for endolymphatic sac is situated posterior to the internal auditory pore11.14(8.26~13.80)mm.The outside of the skull:(1)Pharyngeal tubercle is situated anteromedial to the jugular foramen 22.67(18.34 ~ 26.36)mm(2)Stylomastoid foramen is situated posterolateral to the jugular foramen 5.57(2.86 ~ 9.48)mm(3)Jugular process constitutes a posterior wall of jugular foramen,The occipital condyle constitutes a medial wall of jugular foramen,both are important bony symbols of exposuring jugular foramen.Fugular foramen:(1)including 13 cases of right more than left jugular fossa depth,equal to 1 example,8 cases left greater than right(2)There are 7sides bone bridges,including four sides belong to the type 2 bone bridge,three sides belongs to type 1 bone bridge.Conclutions From the intracranial view,the fissure for endolymphatic sac and internal auditory pore are important anatomical symbol around the jugular foramen;From the cranial appearance,pharyngeal tubercle,stylomastoid foramen,jugular process and occipital condyle are important bony structures around the jugular foramen region.There are irregular shapes,different sizes about jugular foramen,usually on the right side of the aperture is greater than the left side of the aperture.To master the important bony structure around the jugular foramen region is an important precondition of treatment of the jugular foramen region communicating tumors.Part ? the combined approaches in treatment of the jugular foramen region communicating tumorsObjective To provide anatomical basis for the clinical application of the jugular foramen region communicating tumors through comparing the combined far lateral paracondylar-partial transcondylar approach with the combined infralabyrinthinesuboccipital retrosigmoid approach.Methods To compare the explosive areas of jugular foramen region and corresponding anatomic marks by simulating these two kinds of combined approaches under microscope in 16 cadaveric adult heads,at the same time observe the explosive status of extracranial segment of jugular foramen region after removal of the atlas transverse process.Results These two kinds of combined approaches can reveal the intracranial segment and limited extracranial segment of jugular foramen region.The combined far lateral paracondylar-partial transcondylar approach is advantageous to reveal the posteromedial area of jugular foramen,while the combined infralabyrinthinesuboccipital retrosigmoid approach is more advantageous to reveal the posterolater-al area of jugular foramen.The occipital condyle and jugular process are anatomical symbols of the former.The stylomastoid foramen and jugular process are anatomical symbols of the latter.Atlas transverse process resection can extend the exposure of extracranial segment of jugular foramen region(retrostyloid parapharyngeal space).Conclutions With the aid of atlas transverse process resection,the combined far lateral paracondylar-partial transcondylar approach is suitable for processing the jugular foramen region communicating tumors whose principal part was medial to the foramen,while the combined infralabyrinthine-suboccipital retrosigmoid approach is more suitable for processing the jugular foramen region communicating tumors whose principal part was lateral to the foramen.