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Journal of Cerebrovascular and... Dec 2020Jugular foramen paragangliomas (JFP) are benign tumors of neural crest origin that are located along the temporal bone in the region of the jugular bulb and middle ear....
Jugular foramen paragangliomas (JFP) are benign tumors of neural crest origin that are located along the temporal bone in the region of the jugular bulb and middle ear. The optimal management of these lesions includes surgical excision with or without preoperative embolization as well as stereotactic radiotherapy. The use of preoperative embolization in the treatment of JFP has shown great promise to bridge patients to surgery by diminishing complication rates and decreasing intraoperative bleeding. We present three successful polyvinyl alcohol (PVA) particle embolizations of patients presenting with symptomatic JFPs. All patients recovered completely in the short term with no bleeding during or after resection of paragangliomas and they were discharged free of their presenting symptoms. Early clinical and imaging diagnosis followed by adequate treatment including preoperative transcatheter particle embolization and surgical or radiosurgical interventions can lead to excellent outcomes.
PubMed: 33334087
DOI: 10.7461/jcen.2020.E2019.09.033 -
Vestnik Otorinolaringologii 2023In this article we present the surgical approaches to the temporal bone paraganglioma based on the anatomical studies.
UNLABELLED
In this article we present the surgical approaches to the temporal bone paraganglioma based on the anatomical studies.
OBJECTIVE
To detalize the anatomy of the jugular foramen according to the comparison of cadaver dissections findings and the CT scans data that were performed before the dissections, for improvement of quality of treatment of patients with temporal bone paraganglioma (Fisch type C).
MATERIAL AND METHODS
The data of CT scans and the steps of the approaches to the jugular foramen (retrofacial and infratemporal approaches with opening of jugular bulb and identification of the anatomical structures of jugular foramen) were analyzed on 10 cadaver heads, 20 sides. Clinical implementation was demonstrated in case of temporal bone paraganglioma type C.
RESULTS
Based on the detail study of the CTs data we revealed the individual features of the temporal bone structures. Due to the results of 3D rendering the average length of the jugular foramen in anterior-posterior direction was 10.1 mm. The length of vascular part was larger than the nervous part. The posterior part had the bigger height wherein the shortest part we detected between jugular ridges, which in some cases caused the dumbbell shape of jugular foramen. According to 3D multiplanar reconstruction the distances between jugular crests (3.0 mm) had the lowest measures and the largest was between internal auditory canal (IAC) and jugular bulb (JB) (8.01mm). At the same time, one of the largest variations of values was also identified between IAC and JB (from 4.39 to 9.84 mm). The distance between the facial nerve in the mastoid segment and JB was variable (from 3.4 to 10.2 mm) and determined by the volume and position of the JB. The results of the dissection corresponded to the measurements according to the CT scans, taking into account the 2-3 mm error due to the massive removal of temporal bone during performing of surgical approaches.
CONCLUSION
The detailed knowledge of the surgical anatomy of the jugular foramen based on a thorough analysis of preoperative CT data is the key to an adequate surgical tactic for the removal of different types of temporal bone paraganglioma while preserving the function of vital structures and the quality of life. A larger study on the big data is needed to determine the statistical relationship between the volume of JB and the size of the jugular crest; the correlation between the dimensions of jugular crests and the tumor invasion in the anterior part of the jugular foramen.
Topics: Humans; Jugular Foramina; Quality of Life; Paraganglioma; Temporal Bone; Cadaver
PubMed: 36867138
DOI: 10.17116/otorino20228801110 -
American Journal of Otolaryngology 2022Capillary hemangiomas are benign vascular lesions that are common in head and neck, but hemangiomas of jugular foramen and temporal bone are rare with only a few cases...
Capillary hemangiomas are benign vascular lesions that are common in head and neck, but hemangiomas of jugular foramen and temporal bone are rare with only a few cases reported in the literature. We present a case report of this rare disease entity highlighting the subtle radiographic nuances that can benefit clinicians when encountered with similar unusual clinical scenario. Although radiographic features of capillary hemangioma can be distinctive, they are not specific. In this case, the lack of significant involvement of the jugular bulb and the absence of the typical pattern of osseous erosion of the jugular carotid spine led to the alternative diagnosis of a rare capillary hemangioma of the jugular foramen.
Topics: Hemangioma, Capillary; Humans; Jugular Foramina; Paraganglioma; Temporal Bone
PubMed: 34973661
DOI: 10.1016/j.amjoto.2021.103348 -
Neurology Jan 1983
Topics: Cranial Nerve Diseases; Humans; Paralysis; Syndrome
PubMed: 6681556
DOI: 10.1212/wnl.33.1.119-a -
Clinical Radiology Jun 1998The jugular foramen, a complex bony canal, transmits vessels and nerves from the posterior cranial fossa through the skull base into the carotid space. It is... (Review)
Review
The jugular foramen, a complex bony canal, transmits vessels and nerves from the posterior cranial fossa through the skull base into the carotid space. It is inaccessible to clinical examination and radiology plays a central role in evaluating this region. Familiarity with the normal anatomy of this area will help in the formulation of differential diagnosis and the assessment of disease extent. Both intracranial and extracranial lesions may affect the jugular foramen in addition to intrinsic abnormalities. Normal variants and artefacts seen on magnetic resonance imaging (MRI) should not be mistaken for pathological processes.
Topics: Brain Neoplasms; Humans; Magnetic Resonance Imaging; Occipital Bone; Skull Base Neoplasms; Temporal Bone; Tomography, X-Ray Computed
PubMed: 9651055
DOI: 10.1016/s0009-9260(98)80268-7 -
Neuroimaging Clinics of North America Aug 1994The jugular foramen varies considerably in size and shape, along with the jugular vein. The foramen is traversed by several vessels and nerves. CT, in various section... (Review)
Review
The jugular foramen varies considerably in size and shape, along with the jugular vein. The foramen is traversed by several vessels and nerves. CT, in various section planes, demonstrates the bone anatomy optimally, whereas MR (including MR angiography) reveals the vascular and soft tissue structures to best advantage. A diverse group of vascular anomalies originate in the foramen and adjacent carotid canal that must be differentiated from tumors. The most common tumor within the jugular foramen is the hypervascular glomus jugulare tumor followed by neurogenic tumors, predominantly the schwannoma. Less common lesions comprise meningioma, hemangiopericytoma, chondrosarcoma, and plasmacytoma. Metastases and malignant tumors arising in adjacent anatomic structures (nasopharynx, parotid, and temporal bone), in advanced stages, may spread to the jugular foramen. Endolymphatic sac tumors arise at the posterior medial aspect of the petrous bone and frequently extend to the jugular foramen. Irregular lytic bone destruction, with enlargement and hypervascularity, demonstrated by CT and MR imaging, are characteristic for glomus jugulare tumors. Benign tumors, most commonly the jugular foramen schwannoma, display an enlarged jugular foramen with well-defined bone margins.
Topics: Bone Diseases; Bone Neoplasms; Diagnostic Imaging; Glomus Jugulare Tumor; Humans; Occipital Bone; Petrous Bone
PubMed: 7952957
DOI: No ID Found -
Neurosurgery Mar 2008We sought to describe the juxtacondylar approach to jugular foramen tumors. (Review)
Review
OBJECTIVE
We sought to describe the juxtacondylar approach to jugular foramen tumors.
METHODS
Through an anterolateral approach, the third segment of the vertebral artery (between C2 and the dura mater) is controlled. The C1 transverse process of the atlas, which is located just inferiorly to the jugular foramen, is then removed. The dissection of the internal jugular vein is performed as high as possible, with control of the IXth, Xth, XIth, and XIIth cranial nerves. If required by a tumor extending into the neck, the internal and external carotid arteries can be exposed and controlled. Through a partial mastoidectomy and after removal of the bone covering the jugular tubercle, the end of the sigmoid sinus and then the posteroinferior part of the jugular foramen are reached.
RESULTS
This technique is efficient to expose tumors extending into the jugular foramen. Contrary to the infratemporal approach, it has the main advantage of avoiding petrous bone drilling and associated potential complications. Lower cranial nerves are well exposed in the neck. In patients with schwannomas, complete resection with selective dividing of only the few involved rootlets can be achieved.
CONCLUSION
The juxtacondylar approach is an efficient approach to tumors located in the jugular foramen. It necessitates control of the third segment of the vertebral artery but has the advantage of avoiding complications associated with petrous bone drilling. Extension beyond the jugular foramen requires combination with an infratemporal or a retrosigmoid approach.
Topics: Brain Neoplasms; Cranial Fossa, Posterior; Humans; Jugular Veins; Neurosurgical Procedures
PubMed: 18424969
DOI: 10.1227/01.neu.0000317375.38067.55 -
Journal of Neurosurgery May 1984Thirteen patients with schwannomas of the jugular foramen were operated on at the Cleveland Clinic between 1974 and 1983. The authors' experience in managing these rare...
Thirteen patients with schwannomas of the jugular foramen were operated on at the Cleveland Clinic between 1974 and 1983. The authors' experience in managing these rare tumors is presented. Three major growth patterns of jugular foramen schwannoma were seen, and it is postulated that the position of the tumor depends on its point of origin from the nerves as they pass through the pars nervosa of the jugular foramen. The more distal lesions will expand inferiorly out of the base of the skull, and the more proximal lesions will enlarge into the posterior fossa. Tumors in the mid region will tend to expand primarily into bone. The schwannoma was primarily intracranial in six patients. In five patients the tumor expanded the bone at the base of the skull, with only a small intracranial component, and in two patients the tumor was primarily extracranial, with a small extension into the bone or posterior fossa. The presentation of the patients varied according to the tumor growth pattern. Deafness, vertigo, and ataxia were present in all patients with a major intracranial component, and in most of these there were only minimal deficits of the jugular foramen nerves. By contrast, lower cranial nerve involvement, including hoarseness and weakness of the trapezius and sternocleidomastoid muscles, occurred in patients in whom the tumor was primarily, within the bone or extracranial. Three of the five patients with the major component of the schwannoma within the bone also had deafness. Symptomatic history was longest in those with tumor mainly involving the bone at the base of the skull, and shortest in patients with entirely extracranial tumor. Surgical resection was accomplished with a joint neurosurgical-otological approach, usually combining a posterior fossa exploration with either a translabyrinthine transcochlear or infralabyrinthine procedure. The exact nature of the operation depended upon the presence of intracranial tumor and on the extent of bone or extracranial involvement. Total excision was performed in all cases. There was no operative mortality, and surgery resulted in loss of function of the ninth, 10th, and 11th cranial nerves in most patients. The major postoperative morbidity consisted of swallowing difficulties and sputum aspiration.
Topics: Adult; Cranial Nerve Neoplasms; Female; Humans; Male; Middle Aged; Neurilemmoma; Radiography
PubMed: 6716139
DOI: 10.3171/jns.1984.60.5.1045 -
The Neurohospitalist Jul 2023Jugular foramen syndrome (JFS) is a lower cranial neuropathy syndrome characterized by dysphonia and dysphagia. The syndrome is caused by dysfunction of the...
Jugular foramen syndrome (JFS) is a lower cranial neuropathy syndrome characterized by dysphonia and dysphagia. The syndrome is caused by dysfunction of the glossopharyngeal, vagus, and spinal accessory nerves at the level of the pars nervosa and pars vascularis within the jugular foramen. There are numerous etiologies for JFS, including malignancy, trauma, vascular, and infection. Here, we present the case of a healthy adult man who developed JFS secondary to an atypical presentation of Varicella Zoster meningitis, and was promptly diagnosed and treated with rapid symptom resolution. We diagnosed the patient using specialized skull-based imaging which detailed the jugular foramen, as well as CSF analysis. This case highlights the clinical value of detailed structural evaluation, consideration for infection in the absence of systemic symptoms, and favorable outcomes following early identification and treatment.
PubMed: 37441204
DOI: 10.1177/19418744221116717