| 2. |
小宗 徳孝, 松尾 聡, 三木 浩一, 中川 尚志, Microsurgical Anatomy of the Jugular Process: Cadaveric and Radiological study, the 27th Annual Meeting of the North American Skull Base Society in New Orleans, Louisiana, March 3–5, 2017, 2017.03, Background:
The jugular process forms the posterior border of the jugular foramen. This process is the critical structures for the access to the jugular foramen. However, the microsurgical anatomy of this structure has not been described well in most modern text.
Object:
The objective is to elucidate the microsurgical anatomy of the jugular process through cadaveric dissection and to investigate the radiological feature of the process.
Materials and Methods:
Cadaveric and radiological study. Five adult cadaveric specimens and a dry skull were examined to expose the detailed anatomy of the jugular process and its surrounding structures. Thirty one computed tomography angiography images (62 sides) were examined to investigate the relationships between the course of the sigmoid sinus and the morphological feature of the process.
Results:
Cadaveric study shows that the jugular process is closely related to the sigmoid sinus, jugular bulb, rectuc capitis lateralis muscle and lateral atranto-occcipital ligament, and the process is a key landmarks for the accessing the jugular foramen both from posterior and lateral. Radiographic study shows the morphological features of this process. Nine out of sixty-two sigmoid sinuses protrude inferiorly into the jugular process. The jugular bulb is categorized into two types: the sloped type and the morphologically bulbed type. The process located below the sigmoid sinus in the latter tends to have a steaper angle, thus proving more difficult to remove from the posterior aspect for the exposure of the posterior wall of the jugular foramen.
Conclusion:
The jugular process forms the posterior border of the jugular foramen. The resection of the jugular process is crucial in open the jugular foramen from the posterior and lateral aspect. The detailed knowledge of this structure is essential to approach the jugular foramen. The precise understanding the microsurgical anatomy of the process and preoperative evaluation of the relationships between the process and the sigmoid sinus makes surgical access to the jugular foramen safe and accurate.
. |
