Temporal Bone Malignancies Involving the Jugular Foramen: Diagnosis and Management

ORL ◽  
2014 ◽  
Vol 76 (4) ◽  
pp. 227-235 ◽  
Author(s):  
Wei Li ◽  
Ting Zhang ◽  
Chunfu Dai
Keyword(s):  
Temporal Bone ◽  
Jugular Foramen ◽  
Diagnosis And Management

Tumors of the Jugular Foramen—Diagnosis and Management

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Ricardo Ramina ◽  
Joao Jarney Maniglia ◽  
Yvens Barbosa Fernandes ◽  
Jorge Rizzato Paschoal ◽  
Maurício Coelho Neto
Keyword(s):  
Jugular Foramen ◽  
Diagnosis And Management

scholarly journals Retrosigmoid transmeatal and suprajugular approach for cerebellopontine angle meningioma: operative video

2017 ◽  
Vol 43 (videosuppl2) ◽  
pp. V3 ◽  
Author(s):  
Ken Matsushima ◽  
Michihiro Kohno
Keyword(s):  
Vagus Nerve ◽  
Temporal Bone ◽  
Surgical Management ◽  
Cerebellopontine Angle ◽  
Jugular Foramen ◽  
Bone Drilling ◽  
Operative Field ◽  
Nerve Monitoring ◽  
Brainstem Surgery ◽  
Neurovascular Structures

Surgical management of cerebellopontine angle meningiomas is challenging due to the intricate neurovascular structures within the limited operative field and the compression of eloquent structures including the brainstem. Surgery on tumors extending into the temporal bone is especially difficult and demands complicated approaches. However, modifications to the retrosigmoid approach utilizing intradural temporal bone drilling enable access to such tumoral extensions without any additional invasive approaches. This video demonstrates the case of a cerebellopontine angle meningioma extending into the internal acoustic meatus and jugular foramen that was surgically treated through the retrosigmoid transmeatal and suprajugular approaches under continuous vagus nerve monitoring.The video can be found here: https://youtu.be/aUD1vr6TbOc.

Epidermoid Cysts and Cholesterol Granulomas Centered on the Posterior Fossa: Twenty Years of Diagnosis and Management

Neurosurgery ◽  
1987 ◽  
Vol 21 (6) ◽  
pp. 798-805 ◽  
Author(s):  
Howard Ian Sabin ◽  
Lorenzo Tommaso Bordi ◽  
Lindsay Symon
Keyword(s):  
Posterior Fossa ◽  
Diagnostic Procedures ◽  
Jugular Foramen ◽  
Neurological Deficits ◽  
Petrous Apex ◽  
Epidermoid Cysts ◽  
Diagnosis And Management ◽  
Presenting Symptoms ◽  
Review Period ◽  
Contrast Ventriculography

Abstract The clinical features, diagnosis, and management of 23 posterior fossa epidermoid cysts and 9 petrous apex lesions presenting to one unit over a period of 20 years are summarized. Of the epidermoid cysts, 13 were entirely infratentorial, but the other 10 had an additional supratentorial component. Presenting symptoms and signs were usually long-standing and at onset had often been vague and nonspecific. With time, however, a variety of neurological deficits that depended on the site of the lesion developed. These were generally combinations of cerebellopontine (CP) angle and jugular foramen syndromes, deafness, facial palsy, and motor weakness. Diagnostic procedures have changed greatly over the review period. Computed tomography and magnetic resonance imaging have replaced air encephalography and contrast ventriculography. The better preoperative localization of these lesions allows rational planning of the surgical approach required for optimal tumor exposure, which is essential for any attempt at total excision, considering the large size of the majority of these tumors when diagnosed. We favor operation through a posterior fossa craniectomy for those tumors restricted to the CP angle or 4th ventricle, but routinely use a combined supra- and infratentorial approach if the lesion has a more rostral component. The infiltrating nature of epidermoid cysts within the cranium compromises the extent of excision if neurological deficit is not to be increased, but we attempt as complete an excision of tumor and capsule as possible in the hope that many years will pass before symptoms recur. Cholesterol granulomas seem to respond well to simple cavity drainage and have shown no tendency to recur.

scholarly journals Modified classification of infralabyrinthie cholesteatoma and scale of cholesteatoma extention

2020 ◽  
pp. 86-94
Author(s):  
K. M. Diab ◽  
O. S. Panina ◽  
O. A. Pashchinina
Keyword(s):  
Temporal Bone ◽  
Surgical Approach ◽  
Internal Auditory Canal ◽  
Petrous Bone ◽  
Jugular Foramen ◽  
Petrous Apex ◽  
Occipital Condyle ◽  
Epidermal Cyst ◽  
Scientific Center

Introduction. Petrous temporal bone (PTB) cholesteatoma is an epidermal cyst, which is the result of uncontrolled growth of keratinizing squamous epithelium in the petrous part of the temporal bone. Cholesteatoma is classified into congenital, acquired, and iatrogenic.Objective. To discuss the classification of infralabyrinthine petrous bone cholesteatoma (PBC), add modified classificationand to propose adequate differential surgical management.Methods. The setting was a National Medical Scientific Center of Otorhinolaryngology FMBA (Russia). The data of 14 patients who underwent surgery for different variations of infralabyrinthine PBC from 2017 till 2020 were analyzed and included into the study (with respect to localization type of the approach used, complications, recurrences and outcome). The follow-up period ranged from 6 to 34 months with a median of 18 months.Results. Based on preoperative CT scans and intraoperative findings a Scale of Cholesteatoma extension CLIF(APO) and Modified classification of infralabyrinthine cholesteatoma (in relation to mastoid segment of the facial nerve) are proposed. The scale includes the main anatomical structures of the temporal bone and the adjacent parts of the occipital and sphenoid bones, which may be involved in the cholesteatoma process: cochlea, vestibule and semicircular canals, internal auditory canal, jugular foramen, bony chanal of the internal carotid artery, petrous apex, occipital condyle. Based on the modified classification and scale we present an algorithm for decision making and surgical approach choosing.Conclusion. The implementation of the Scale of Cholesteatoma Extension in Otology and Radiology practice will allow to preoperatively diagnose the extension of PBC, unify the data of the localization of cholesteatoma; allows standardization in reporting and continuity at all stages of treatment. The modified classification proposed by us in this article facilitate the algorithm for selecting the type of surgical approach and determine whether to perform less aggressive combined microscopic approaches with endoscopic control.

scholarly journals Endoscopic Anatomy of Hypotympanum Surgical Implications

2018 ◽  
Vol 01 (02) ◽  
pp. 058-067
Author(s):  
Rajesh Boddepalli ◽  
Sreerama Boddepalli
Keyword(s):  
Temporal Bone ◽  
Local Anesthesia ◽  
Type A ◽  
Jugular Foramen ◽  
Type B ◽  
Cadaveric Dissection ◽  
Endoscopic Anatomy ◽  
Type C ◽  
Four Levels ◽  
Temporal Bones

Abstract Objective To assess the endomeatal endoscopic morphological anatomy of hypotympanum under local anesthesia and further cadaveric dissection of temporal bone to know complete anatomical details of hypotympanum. Materials and Methods Two hundred six cases of live operations were studied, these included 160 cases of simple dry perforations for myringoplasty and 46 cases of stapedectomy operations. All operations were performed under local anesthesia using a 0-degree, 4-mm endoscope. The hypotympanum was visualized. Twenty wet temporal bones were dissected endoscopically and complete hypotympanic details were studied. Results Out of 206 cases, 94 cases (45%) were found to be type A; 51 cases (25%) were type B and 60 cases (30%) were type C hypotympanum. Wet cadaveric bones were dissected to visualize the transmeatal endoscopic jugular foramen in four levels (levels 1, 2, 3, and 4).

Tumors of the Jugular Foramen: Diagnosis and Management

2005 ◽  
Vol 57 ◽  
pp. 59-68 ◽  
Author(s):  
Ricardo Ramina ◽  
Joao Jarney Maniglia ◽  
Yvens Barbosa Fernandes ◽  
Jorge Rizzato Paschoal ◽  
Leopoldo Nizan Pfeilsticker ◽  
...  
Keyword(s):  
Jugular Foramen ◽  
Diagnosis And Management

Neurilemoma of the Jugular Foramen Trans Mastoid Removal

1978 ◽  
Vol 87 (3) ◽  
pp. 313-317 ◽  
Author(s):  
William H. Call ◽  
Jack L. Pulec
Keyword(s):  
Clinical Trial ◽  
Temporal Bone ◽  
Internal Jugular Vein ◽  
Posterior Fossa ◽  
Jugular Vein ◽  
Jugular Foramen ◽  
Facial Recess ◽  
Cervical Portion ◽  
Upper Cervical

— The authors present two cases in which the palsies of the IX, X, XI and XII nerves heralded the presence of a neurilemoma within the jugular foramen. Temporal bone polytomography, retrograde jugular venography, and pantopaque posterior fossa myelography allowed the nature and extent of the tumor to be predicted accurately prior to the operation. The tumors were completely removed using a transmastoid-extended facial recess approach without labyrinthectomy, supplemented in one case by exploration of the upper cervical portion of the internal jugular vein. This technique has avoided the complications which attend removal by way of the posterior fossa. We feel that transmastoid removal merits more extensive clinical trial.

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