The Combined Transmastoid Transjugular Transtubercular High Cervical Approach for Resection of Jugular Foramen Tumors

• 발행기관: 대한두개저학회
• 저자명: 안정용(Jung Yong Ahn) 심유식(Yu Shik Shim) 장종희(Jong Hee Chang) 이규성(Kyu Sung Lee)
• 간행물 정보: 『대한두개저학회지』제3권 제1호, 26~30쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2008.06.30

영문 초록

Objective : Deep location, hypervascularization, involvement of cranial nerves and vessels, and large extension within the posterior fossa are the main difficulties for surgical resection of the jugular foramen tumors. We describe a combined transmastoid transjugular transtubercular high cervical approach for radical resection of these tumors. Methods : Six patients with jugular foramen tumors were surgically treated using combined transmastoid transjugular transtubercular high cervical approach between January 2000 and June 2008. The complex approach for total jugular foramen exposure can be simplified in a stepwise fashion: 1) postauricular infratemporal incision; 2) retrolabyrinthine mastoidectomy; 3) high cervical exposure; 4) Lateral suboccipital craniotomy and transtubercular exposure; 5) removal of the internal jugular vein (IJV), jugular bulb, and sigmoid sinus; and 6) intradural exposure. Results : Gross total resection was achieved in 5 patients and subtotal resection in one patient. The histologic examination of the tumors revealed as follows: schwannoma (3 cases), meningioma (1 case), paraganglioma (1 case), and chondrosarcoma (1 case). The most frequent complication was a new deficit of lower cranial nerves. There were no facial nerve injury or cerebrospinal fluid leakage. Conclusions : The combined transmastoid transjugular transtubercular high cervical approach described above allows for single-staged radical resection of large complex jugular foramen tumors. This approach has the advantage of providing total exposure of the jugular foramen with multidirectional angles of attack without facial nerve transposition.

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Introduction

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Discussion

키워드

Jugular foramen Skull base Surgical approach Paraganglioma schwannoma meningioma