TY - JOUR
T1 - Microsurgical anatomy of the jugular process as an anatomical landmark to access the jugular foramen
T2 - A cadaveric and radiological study
AU - Komune, Noritaka
AU - Matsuo, Satoshi
AU - Miki, Koichi
AU - Matsushima, Ken
AU - Akagi, Yojiro
AU - Kurogi, Ryota
AU - Iihara, Koji
AU - Matsushima, Toshio
AU - Inoue, Tooru
AU - Nakagawa, Takashi
N1 - Publisher Copyright:
Copyright © 2018 by the Congress of Neurological Surgeons
PY - 2019/4/1
Y1 - 2019/4/1
N2 - BACKGROUND: The jugular process forms the posteroinferior surface of the jugular foramen and is an important structure for surgical approaches to the foramen. However, its morphological features have not been well described in modern texts. OBJECTIVE: To elucidate the microsurgical anatomy of the jugular process and examine its morphological features. METHODS: Five adult cadaveric specimens were dissected in a cadaveric study, and computed tomography data from 31 heads (62 sides) were examined using OsiriX (Pixmeo SARL, Bernex, Switzerland) to elucidate the morphological features of the jugular process. RESULTS: The cadaveric study showed that it has a close relationship with the sigmoid sinus, jugular bulb, rectus capitis lateralis, lateral atlanto-occipital ligament, and lateral and posterior condylar veins. The radiographic study showed that 9/62 sigmoid sinuses protruded inferiorly into the jugular process and that in 5/62 sides, this process was pneumatized. At the entry of the jugular foramen, if the temporal bone has a bulb-type jugular bulb, and if surgery concerns the right side of the head, the superior surface of the jugular process is more likely to be steep. CONCLUSION: The jugular process forms the posteroinferior border of the jugular foramen. Resection of the jugular process is a critical step for opening the jugular foramen from the posterior and lateral aspects. Understanding the morphological features of the jugular process, and preoperative and radiographical examination of this process thus help skull base surgeons to access the jugular foramen.
AB - BACKGROUND: The jugular process forms the posteroinferior surface of the jugular foramen and is an important structure for surgical approaches to the foramen. However, its morphological features have not been well described in modern texts. OBJECTIVE: To elucidate the microsurgical anatomy of the jugular process and examine its morphological features. METHODS: Five adult cadaveric specimens were dissected in a cadaveric study, and computed tomography data from 31 heads (62 sides) were examined using OsiriX (Pixmeo SARL, Bernex, Switzerland) to elucidate the morphological features of the jugular process. RESULTS: The cadaveric study showed that it has a close relationship with the sigmoid sinus, jugular bulb, rectus capitis lateralis, lateral atlanto-occipital ligament, and lateral and posterior condylar veins. The radiographic study showed that 9/62 sigmoid sinuses protruded inferiorly into the jugular process and that in 5/62 sides, this process was pneumatized. At the entry of the jugular foramen, if the temporal bone has a bulb-type jugular bulb, and if surgery concerns the right side of the head, the superior surface of the jugular process is more likely to be steep. CONCLUSION: The jugular process forms the posteroinferior border of the jugular foramen. Resection of the jugular process is a critical step for opening the jugular foramen from the posterior and lateral aspects. Understanding the morphological features of the jugular process, and preoperative and radiographical examination of this process thus help skull base surgeons to access the jugular foramen.
KW - Jugular foramen
KW - Jugular process
KW - Skull base
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U2 - 10.1093/ons/opy198
DO - 10.1093/ons/opy198
M3 - Article
C2 - 30873560
AN - SCOPUS:85062976544
SN - 2332-4252
VL - 16
SP - 486
EP - 495
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 4
ER -