The anatomy of the inferior petrosal sinus, glossopharyngeal nerve, vagus nerve, and accessory nerve in the jugular foramen.
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PURPOSE To define the variations of the courses of the cranial nerves and the inferior petrosal sinuses as they enter and traverse the jugular foramen. METHODS Thirty-nine cadaveric specimens containing the jugular foramen were scanned with 1-mm contiguous axial and coronal CT sections. Each specimen was dissected to evaluate the position of the cranial nerves and inferior petrosal sinus as they entered the jugular foramen. RESULTS The glossopharyngeal nerve entered the most superior, anterior, and medial aspect of the jugular foramen and descended in the anterior portion of the jugular foramen, often within a groove. The vagus and accessory nerves could not be separated by CT. They entered the jugular foramen most often anterior or anterior and inferior to the jugular spine of the temporal bone and descended in a position ranging from medial to anterior to the jugular vein. The inferior petrosal sinus most often coursed inferior to the horizontal portion of the glossopharyngeal nerve and entered the jugular system in the jugular foramen, at the exocranial opening or below the skull base. A pars nervosa and pars venosa could be identified only at the endocranial opening, where the jugular spine separated the pars nervosa containing the inferior petrosal sinus and three cranial nerves from the pars venosa containing the jugular vein. CONCLUSION Our evaluation demonstrated anatomic variation in the area of the jugular foramen.Keywords:
Jugular foramen
Inferior petrosal sinus
Glossopharyngeal nerve
Cranial nerves
Sinus (botany)
Foramen
Internal jugular vein
Jugular vein
Sigmoid sinus
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The jugular foramen was examined in 300 Anatolian skulls from the 17th and 18th centuries. In 61.6% the foramen was larger on the right and in 26% on the left, with the remainder being of almost equal size. An obvious dome caused by a superior jugular bulb was present bilaterally in 49%, on the right only in 36%, on the left only in 6%; it was absent bilaterally in 10.3%. Complete bony septation occurred in 5.6% on the right and in 4.3% on the left, partial septation was observed in 2.6% on the right and in 19.6% on the left. Another foramen which is completely separated by a spicule of bone and which transmits the inferior petrosal sinus was present in 5.6% of skulls on the right and in 4.6% on the left.
Jugular foramen
Foramen
Inferior petrosal sinus
Occipital bone
Sinus (botany)
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The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy.
Jugular foramen
Foramen
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A variety of lesions may occur in the jugular foramen, arising from the structures normally found within the jugular foramen or from contiguous structures. The most common jugular foramen lesions are nontumoral pseudolesions (eg, asymmetrically enlarged jugular foramen, high or protruding jugular bulb) and tumors (eg, paraganglioma, metastasis). In nontumoral pseudolesions, computed tomography (CT) demonstrates smooth, intact margins of the jugular foramen. Turbulent or slow flow in a high or protruding jugular bulb can result in loss of the flow void and contrast enhancement at magnetic resonance (MR) imaging, thereby mimicking real disease. Use of flow-sensitive techniques or MR angiography will help clarify confusing cases. In cerebral venous thrombosis, CT findings are often normal. At conventional MR imaging, flow-related enhancement and in-plane, turbulent, or slow flow can cause loss of the flow void and thus mimic thrombosis. Consequently, phase-contrast MR venography is the imaging modality of choice in the assessment of cerebral venous thrombosis. Most tumoral lesions of the jugular foramen manifest at CT as areas of infiltrative bone destruction, although schwannoma and meningioma cause smooth enlargement of the jugular foramen. In addition, most of these tumors have low to intermediate signal intensity on T1-weighted MR images and intermediate to high signal intensity on T2-weighted MR images and enhance strongly after the administration of contrast material. Careful analysis of these imaging features and correlation with clinical manifestations can allow a more specific diagnosis.
Jugular foramen
Jugular vein
Foramen
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Abstract Introduction Jugular foramen is one of the most fascinating foramina of the human skull. It is a complex, irregular bony canal located between the occipital bone and petrous part of the temporal bone. Many important structures, like 9th, 10th, 11th cranial nerves, meningeal branch of occipital and ascending pharyngeal arteries, internal jugular vein, and inferior petrosal sinus, are passing through it. The jugular fossa has a septum and a dome. The septum divides the foramen into two compartments: anteromedial compartment (pars nervosa) and posterolateral compartment (pars vascularis). The dome contains superior bulb of internal jugular vein. The architecture of the foramen varies in size, shape, and laterality besides differences related to sex and race. The morphometric measurements of jugular foramen are very important for neurosurgeries and head and neck surgeries. Objectives The aim of the present study is to study the morphology of jugular foramen along with its dimensions, compartments, presence of partial or complete septa and dome. Materials and Methods A total number of 60 jugular foramina were examined from 30 adult dry human skulls of unknown age and sex from the Department of Anatomy, PSG Institute of Medical Sciences and Research, Coimbatore. Measurements were taken using Digital Vernier calipers. Results were analyzed statistically. Results The length, width, and surface area of jugular foramen of right side were measured and compared with the left side. Length and width of the jugular foramen was significantly higher on the right side. The presence of partial septum was found in 27 skulls (90%) on the right side and 29 skulls (99.7%) on the left side, respectively. Dome was present in 100% of the jugular foramina on the right side and 90% of the jugular foramina on the left side. Separate opening for inferior petrosal sinus was found in eight skulls (27%) on the right side and four skulls (13%) on the left side. Conclusion This study provides a clear understanding of anatomy of jugular foramen and supports the reported morphometric variations. The morphometric variations of jugular foramen in the parameters of the skull are probably due to ethnic and racial factors. Knowledge of these variations is important for neurosurgeons and radiologists who deal with space occupying lesions of the structures surrounding jugular foramen. This study may be helpful for ENT surgeons while performing middle ear surgeries.
Jugular foramen
Inferior petrosal sinus
Occipital bone
Foramen
Sinus (botany)
Internal jugular vein
Foramen ovale (heart)
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Aim:To study the course and configuration of nerve and vascular in the region of jugular foramen.Methods:The microsurgical anatomy of jugular foramen was observed in 10 fixed cadavers with each consisting of the whole head and neck and injected with latex. The jugular foramen was exposed step by step via the surgical approach of cervix-mastoid.Results:Jugular bulb was located in jugular foramen,which was the moving part between sigmoid sinus and internal jugular vein,and possessed their characteristics; The glossopharyngeal nerve left skull through jugular foramen with fascia singly,which had space to the other(vagus nerve,accessory nerved and hypoglossal nerve).Conclusion:Knowing well of microsurgical anatomy of jugular foramen would be in favor of protecting the important nerve and vascular in surgery.
Jugular foramen
Sigmoid sinus
Glossopharyngeal nerve
Accessory nerve
Internal jugular vein
Inferior petrosal sinus
Foramen
Hypoglossal nerve
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THE JUGULAR FORAMEN, based on these studies of microsurgical anatomy, is divided into three compartments: two venous and a neural or intrajugular compartment. The venous compartments consist of a larger posterolateral venous channel, the sigmoid part, which receives the flow of the sigmoid sinus, and a smaller anteromedial venous channel, the petrosal part, which receives the drainage of the inferior petrosal sinus. The petrosal part forms a characteristic venous confluens by also receiving tributaries from the hypoglossal canal, petroclival fissure, and vertebral venous plexus. The petrosal part empties into the sigmoid part through an opening in the medial wall of the jugular bulb between the glossopharyngeal nerve anteriorly and the vagus and accessory nerves posteriorly. The intrajugular or neural part, through which the glossopharyngeal, vagus, and accessory nerves course, is located between the sigmoid and petrosal parts at the site of the intrajugular processes of the temporal and occipital bones, which are joined by a fibrous or osseous bridge. The glossophyryngeal, vagus, and accessory nerves penetrate the dura on the medial margin of the intrajugular process of the temporal bone to reach the medial wall of the internal jugular vein. The operative approaches, which access the foramen and adjacent areas and are demonstrated in a stepwise manner, are the postauricular transtemporal, retrosigmoid, extreme lateral transcondylar, and preauricular subtemporal-infratemporal approaches.
Sigmoid sinus
Inferior petrosal sinus
Jugular foramen
Glossopharyngeal nerve
Infratemporal fossa
Cranial nerves
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The jugular foramen at the base of the skull varies in shape and size the foramen lies at the petrous part of temporal bone and behind by the occipital bone.It's irregular in shape.Usually the right foramen is larger than the left.The variation in the foramen is observed in different racial group and sexes.The shape and size of foramen is inversely related to size of sigmoid sinus.Petrosal portion contains the inferior petrosal sinus.Sigmoid portion receives the sigmoid sinus.Intrajugular portion contains cranial nerves IX, X and XI.AIM: To analyze the length and width of jugular foramen.To determine the side dominance of the foramen.MATERIALS AND METHODS: A total of 32 jugular foramen in dry adult skulls from Department of Anatomy, CHRI were used for the present study.Sagittal and transverse diameters were measured using digital vernier caliper.OBSERVATIONS: The overall dimensions of Jugular foramen were recorded on both sides.The mean transverse diameter (width) on the right and the left side were 11.779mm and 10.901mm respectively.The mean sagittal diameter (length) on the right and left side were 10.141mm and 09.025mm.In 62.5% of cases the right foramen was larger , in 37.5% of cases left foramen was larger than the right.Dome was found bilaterally in 50% of cases, The unilateral presence of dome was equally distributed to both sides.Jugular process was found bilaterally in 18.75%, right side 31.25% and left side in 18.75% of cases.The process was absent in 31.25%cases.Complete Septation of the foramen was found in 12.5% on right side, 6.25% on left side.Partial Septation was seen in 87.5% on right side, in 93.74% on left side.CONCLUSION: In comparison with the previous studies, the width of the Jugular foramen is slightly higher where as the length is slightly lower.There is an increase in the occurrence of bony partition compared to the previous study.Dimension, dome and Septation were significantly higher on right side than on left.Jugular foramen serves as an important land mark during surgeries of posterior cranial fossa.
Jugular foramen
Foramen
Sigmoid sinus
Calipers
Inferior petrosal sinus
Sinus (botany)
Occipital bone
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✓ The radiographic anatomy of the jugular foramen is described. Normal variations in size and configuration are discussed and principal pathological configurations listed. The radiographic features of complete separation of the jugular foramen into separate neural and vascular components are presented.
Jugular foramen
Foramen
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Objective To study the dural architecture of the jugular foramen and the course and configuration of the cranial nerves in the jugular foramen. Methods The microsurgical anatomy of the jugular foramen was observed in 10 fixed cadavers with each consisting of the whole head and neck and injected with latex. The jugular foramen was exposed step by step via the infratemporal fossa type A of Fisch in 5 cadavers and the combined cervicomastoid and suboccipital far-lateral approach in 5 cadavers. Results A dural septum separated the glossopharyngeal nerve from the fascicles of vagus nerve and accessory nerve at the intracranial opening. The cranial nerves remained fasciculated within the foramen. All of these nerve fascicles lay medial to the superior jugular bulb with the glossopharyngeal nerve located anteriorly and the accessory nerve posteriorly. The rootlets from the cranial root of accessory nerve were considered to join the spinal root, traveling with it briefly, then separated within the jugular foramen to become a part of the vagus nerve. The jugular bulb and adjacent part of jugular vein received drainage from the sigmoid and inferior petrosal sinuses, the vertebral venous plexus, the venous plexus of the hypoglossal canal, the condylar emissary vein, and the vein coursing along the inferior aspect of the petroclival fissure. Conclusion The jugular foramen can be divided into petrosal part, intrajuguar part, and sigmoid part. The cranial nerves within the jugular foramen maintain multifascicular and the nerve fascicles are separated between each other. The accessory nerve has no cranial root; it only consists of the structure hitherto as its spinal root.
Jugular foramen
Accessory nerve
Inferior petrosal sinus
Glossopharyngeal nerve
Cranial nerves
Infratemporal fossa
Sigmoid sinus
Cranial cavity
Occipital condyle
Foramen
Internal jugular vein
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With advances in the lateral approaches to the skull base and the increasing success of the management of jugular foramen lesions, a thorough knowledge of the anatomy of this region is needed. The purpose of the present work is to study the detailed microsurgical anatomy of the lower skull base and the jugular foramen area as seen through the lateral approaches. Forty preserved skull base specimens and 5 fresh cadavers were dissected. The shape of the jugular bulb and its relationship to nearby structures were recorded. The different venous connections of the bulb were noted. The hypoglossal canal was identified and its contents were observed. The lower cranial nerves were studied at the level of the upper neck, at their exit from the inferior skull base, and in the jugular foramen. The results of the present study showed the complex and variable anatomy of this area. The classic compartments of the jugular foramen were not always present. Cranial nerves IX through XI followed different patterns while passing through the jugular foramen, being separated from the jugular bulb by bone, thick fibrous tissue, or thin connective tissue.
Jugular foramen
Foramen
Cranial nerves
Occipital bone
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Citations (46)