The third group of glomus jugulare tumors 24 patients was managed according to our current treatment protocol, which aims to preserve jugular foramen function. The detection of individual cranial nerves in the intraforaminal portion of the jugular foramen and hypoglossal canal is useful in diagnostic imaging 1. Imaging of jugular foramen antibodies or varicella zoster dna in the cerebrospinal fluid. Start studying skull foramen contents and associated bones. Tumors of the jugular foramen pdf tumors of the jugular foramen pdf free download, tumors of the jugular foramen pdf, tumors of the jugular foramen ebook content this book covers all aspects of the diagnosis and treatment of tumors of the jugular foramen cranial base lesions that present particular diagnostic and management difficulties. Case presentation a case of vernet syndrome associated with internal jugular phlebectasia nicholas c.
Jugular foramen schwannomas jfss are relatively rare, benign lesions that account for 10% to 30% of all tumors in the region of the jugular foramen. Skull foramen contents and associated bones questions and. Jugular foramen involvement does not fit into the cephalocele classification. Feb 17, 2012 jugular foramen syndrome, or vernets syndrome, is characterized by dysfunction of the ix, x, and xi cranial nerves. There is a separate paragraph on lesions of the jugular foramen in children. Tumors with extensive extra and intracranial components necessitate both radical neck dissection maneuvers combined with skull base approaches. Preoperative jugular neuropathies had decreased to 16%, which reflected a greater number of smaller tumors. Tumors involving the jugular foramen can extend as follows. Cranial nerve foramina are integral exits from the confines of the skull. Schwannomas involving the jugular foramen are rare lesions, and no consensus exists on their management. The jugular foramen courses anteriorly, laterally, and inferiorly as it insinuates itself between the petrous temporal bone and the occipital bone gross anatomy. We present a single surgeons perspective in managing these difficult tumors.
Pdf differential diagnosis of jugular foramen lesions. The aim of this study is to describe the presenting symptoms, radiographic findings, operative procedures, and postoperative outcome of five histologically confirmed cases of chondrosarcomas arising from the jugular foramen. Jugular foramen definition of jugular foramen by the free. The right jugular foramen large arrow is larger than the left small arrow, due to the asymmetry of the intracranial venous drainage. In addition to its intrinsic pathologic conditions, a variety of lesions can arise from the contiguous surrounding structures and invade the foramen. Tumors of the jugular foramen remain challenging lesions despite advances in surgical technique and medical technology. It is formed in front by the petrous portion of the temporal bone, and behind by the occipital bone. The jugular foramen is usually described as being divided into two parts by a fibrous or bony septum, called the jugular spine, into. It is located behind the carotid canal and is formed in front by the petrous portion of the temporal, and behind by the occipital. Part ii, presented here, focuses on the foramina of the posterior cranial fossa and discusses each foramen.
Endoscopeassisted, transmastoid, high cervical approach. Jugular foramen syndrome and allied syndromes neurology. The jugular foramen is a large aperture in the base of the skull. For the six who underwent surgical excision, the surgical procedure used, cranial nerve function results, audiometric results, perioperative complications, and other. Primary meningiomas occurring within the jugular foramen are exceedingly rare lesions presumed to originate from arachnoid. Quizlet flashcards, activities and games help you improve your grades. Evolution of the intracranial approaches to jugular foramen. Imaging of jugular foramen jugular foramen, albeit complex, is essentially a bony conduit transmitting nerves and vessels from the posterior cranial fossa to the nasopharyngeal carotid space. Imaging findings of jugular foramen meningocele in a. Download fulltext pdf download fulltext pdf differential diagnosis of jugular foramen lesions article pdf available in skull base surgery 191. The left jugular foramen is filled with a slightly inhomogeneous hypointense lesion. Although schwannomas are usually solid tumors, they occasionally exhibit. The term foramen is not strictly accurate because the jf resembles a canal with endocranial and exocranial openings. Langerhans cell histiocytosis in the jugular foramen pdf.
The objective of this study is to analyze the management and outcome in a series of primary jugular foramen meningiomas collected at a single center. Jugular foramen definition of jugular foramen by medical. Chondrosarcomas of the jugular foramen sanna 2008 the. The jugular foramen is usually described as being divided into two parts by a fibrous or bony septum, called the jugular spine, into the pars nervosa. An auricular branch supplies the exterior of the ear drum, posterior wall of the external auditory meatus and cranial surface of the auricle. The left foramen large arrow is larger than the right foramen small arrow. Five cases of surgically treated and pathologically confirmed jugular foramen chondrosarcomas were identified. The emphasis is on the various tumours that can be encountered. This paper reports on 20 such cases treated in our centers.
Schwannomas arising from the jugular foramen jf are very rare and account for only 2. Langerhans cell histiocytosis in the jugular foramen. Surgical management of jugular foramen meningiomas. Jugular foramen meningiomas are rare lesions and are the third most frequent jugular foramen tumor after glomus jugulare tumors and schwannomas of the lower cranial nerves. Chondrosarcomas of the jugular foramen are extremely rare tumors. Asymmetrically large jugular bulb radiology reference. Rhoton and others published jugular foramen find, read and cite all the research you need on researchgate. The jugular foramen courses anteriorly, laterally, and inferiorly as it insinuates itself between the petrous temporal bone and the occipital bone. The jugular foramen jf, sometimes referred to as the posterior foramen lacerum, is situated in the floor of the posterior fossa posterolateral to the carotid canal, between the petrous temporal bone anterolaterally and the occipital bone posteromedially fig. The pharyngeal nerves form a plexus with glossopharyngeal and sympathetic fibres. The branchiomotor supply to pharynx and larynx is derived.
The jugular foramen jf is a bony channel that transmits vessels and cranial nerves ix, x, and xi cnix, cnx, and cnxi through the skull base into the carotid space. In addition to a number of anatomic variants and imaging artifacts, it may be affected by a variety of primary and secondary lesions. Indeed, only two case reports were identified in the literature at the time that this report was prepared 7, 8. The purpose of this study was to assess how well the anatomy of the jugular foramen jf could be displayed by 3t mr imaging by using a 3d contrastenhanced fast. In the jugular foramen, the gpn runs through the anteromedial portion or pars. Pulmonary langerhans cell histiocytosis langerhans cell histiocytosis langerhans cell histiocytosis research pulmonary langerhans cell histiocytosis. The payee may view, download, andor print the article for hisher personal, scholarly, research. The superior border of the initial portals should be high enough to cover the retropharyngeal nodes and high jugular nodes approaching the jugular fossa, especially for patients with advanced nodal. Jugular foramen article about jugular foramen by the. Jeanpierre barral, alain croibier, in manual therapy for the cranial nerves, 2009. Paragangliomas in the skull base are ubiquitous in their distribution and arise from paraganglia or glomus cells situated at the following sites. Exiting inferiorly through the jugular foramen, the vagus nerve travels between the internal jugular vein and internal carotid artery within the carotid sheath, giving off three major branches containing special visceral efferent fibers.
Rehabilitation after treatment for jugular foramen lesions. In the jugular foramen a meningeal nerve branches off to supply the dura mater in the posterior cranial fossa. The venous com partm ents consist of a larger posterolateral venous channel. Pdf transsigmoid approach for tumors of the jugular foramen. Paragangliomas glomus jugular tumors the most common tumor to develop in the jf is a paraganglioma. Jugular foramen schwannomas arising from cranial nerves ix, x, xi as means glossopharyngeal nerve, vagal nerve and cranial accessory nerve are rare and they constitute approximately 2.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Anatomical study of jugular foramen in the neck article pdf available in brazilian journal of otorhinolaryngology 861 october 2018 with 50 reads how we measure reads. Transsigmoid approach for tumors of the jugular foramen article pdf available in skull base. It is difficult to conceptualize because it varies in size and shape in different crania, from side to side in the same cranium, and from its intracranial to extracranial end in the same foramen, and because of its complex irregular shape, its curved course, its formation by two bones, and the. The jugular foramen is a large foramen opening in the base of the skull, located behind the carotid canal. Tumors of the jugular foramen pdf download medical books. They may be located within the jf or may extend intracranially andor extracranially. Surgical management of jugular foramen schwannomas with. Jugular foramen syndrome as initial presentation of. A case of vernet syndrome associated with internal jugular. Lower cranial nerve schwannomas involving the jugular foramen. This chapter discusses the jugular fossa with a description of the anatomy, a discussion of the radiological imaging techniques. Asymmetrically large jugular bulbs are entirely normal and asymptomatic.
Surgical resection is the treatment of choice for jugular foramen schwannomas. Notice also the difference in signal intensity of both foramina due to flow. Given their slowgrowing nature, jfss can become quite large before causing symptoms of lower cranial nerve lcn dysfunction, making microsurgical resection a challenge. Jugular foramen schwannomas represent 1030% of all tumors observed around the jugular foramen 16, 21. Nov 30, 2008 jugular foramen schwannomas arising from cranial nerves ix, x, xi as means glossopharyngeal nerve, vagal nerve and cranial accessory nerve are rare and they constitute approximately 2. Jugular foramen syndrome, or vernets syndrome, is characterized by dysfunction of the ix, x, and xi cranial nerves. Colliver, do a 36yearold woman presented with right shoulder weakness after a left parotid tumor resection. Nineteen cases were operated on for removal of the tumors, and the remaining case is being managed by watchful expectancy. The jugular foramen is a large opening between the jugular process of the occiput and the petrosal portion of the temporal bone, set at the posterior end of the petrooccipital suture. Pdf anatomical study of jugular foramen in the neck. Evolution of the intracranial approaches to jugular. The portion of the jugular process that forms the margin of the jugular foramen is indented along its front side at the site of a bifed notch, the jugular notch, which is partially divided into a medial and lateral part by the intrajugular process. Endoscopeassisted, transmastoid, high cervical approach for.
Intracranial schwannomas represent approximately 8% of all primary intracranial tumors 7,28. Morphometric evaluation of the jugular foramen at base of the skull in north indian population addeddate 20190110 07. A thorough understanding of the anatomy of this region is. A 25yearold man with complaints of increasing sensorineural hearing loss and episodes of rotatory vertigo. To describe the presentation, radiographic findings, and surgical management of seven patients who have been diagnosed and treated with jugular foramen schwannomas at the university of utah. Jugular foramen, albeit complex, is essentially a bony conduit transmitting nerves and vessels from the posterior cranial fossa to the nasopharyngeal carotid space. The difficulty in comprehension is created by its varying in size and shape in different crania, from side to side in the same cranium, and from its intracranial to. Variations of the external and internal jugular veins. The pars nervosa is the anteromedial portion of the jugular. Langerhans cell histiocytosis lch is a rare disease of neoplastic proliferation of monocytemacrophage system.
The jugular foramen is difficult to understand and to access surgically 3, 11, 15, 19, 24, 28. Foramina of the human body skull flashcards quizlet. Jugular foramen article about jugular foramen by the free. Jun 19, 2019 the jugular foramen can be very challenging to expose circumferentially and a number of different approaches are categorized into posterior, lateral, and anterior corridors, with different but consistent limitations.
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