Summary
An approach which improves on the conventional suboccipital craniectomy was used to explore a jugular foramen, a hypoglossal neurinoma, and a tentorial meningioma. A postero-medial mastoidectomy supplemented by the conventional suboccipital craniectomy made it possible to expose the entire sigmoid sinus. Subsequent medial retraction of the exposed sigmoid sinus and continuous dura mater and the extradural removal of petrous bone around the jugular foramen exposed the whole extracranial portion of the tumours. The tumours were totally removed by this approach in which the extradural route corresponded to the extracranial portion of the tumours and the suboccipital route to the intracranial portion. Facial nerve and hearing disturbances, which are frequent complications of the previous approaches, did not occur in our cases. Providing adequate exposure with simple surgical procedures and showing no adverse postoperative sequelae, this approach is most suitable for surgery upon jugular foramen tumours with extracranial extension.
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References
Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22: 510–517
Fisch U (1977) Infratemporal approach for extensive tumours of the temporal bone and base of the skull. In: Silverstein Het al (eds) Neurological surgery of the ear. Aesculapius, Birmingham, pp 34–53
Gaillard J, Rebattu JP (1963) Deux nouvelles observations de tumeurs glomiques Tympano-jugulaires opérées par voie cervico-mastoidienne avec déroutation du facial. J Fr Otorhinolaryngol 12: 83–91
Ganz BJ, Fisch U (1983) Modified transotic approach to the cerebellopontine angle. Arch Otolaryngol 109: 252–256
Hakuba A, Hashi K, Fujitani K, Ikuno H, Nakamura T, Inoue Y (1979) Jugular foramen neurinomas. Surg Neurol 11: 83–94
House WF, Hitselberger WE (1976) The transcochlear approach to the skull base. Arch Otolaryngol 102: 334–342
House WF, Cruz AD, Hitselberger WE (1978) Surgery of the skull base: transcochlear approach to the petrous apex and clivus. Otolaryngol 86: 770–779
Kaye AH, Hann JF, Kinney SE (1984) Jugular foramen schwannomas. J Neurosurg 60: 1045–1053
Kempe LG (1970) Operative neurosurgery, Vol 2. Springer, Berlin Heidelberg New York, pp 34–45, 46–53, 72–79
Kumar A, Fisch LL (1983) The infratemporal fossa approach for lesions of the skull base. In: Krayerbühlet al (eds) Advances and technical standards in neurosurgery, Vol 10. Springer Wien, New York, pp 187–220
Miller R (1979) Meningiomas of the posterior fossa. In: Buchheit WAet al (eds) Surgery of the posterior fossa. Raven, New York, pp 99–110
Odake G (1989) Intracranial hypoglossal neurinoma with extracranial extension. Review and case report. Neurosurgery 24: 583–587
Pellet W, Cannoni M, Pech A (1988) The widened transcochlear approach to jugular foramen tumours. J Neurosurg 69: 887–894
Pluchino F, Crivelli G, Vaghi MA (1975) Intracranial neurinomas of the nerves of jugular foramen. Acta Neurochir (Wien) 31: 201–221
Samii M, Ammirati M (1988) The combined supra-infratentorial pre-sigmoid sinus avenue to the petro-clival region. Surgical technique and clinical applications. Acta Neurochir (Wien) 95: 6–12
Sen CN, Sekhar LN (1991) Surgical management of anteriorly placed lesions at the cervical spine and foramen magnum. Neurosurgery 27: 197–204
Tuck RR, Mokri B, Cilluffo JM (1984) Intracranial schwannoma of the hypoglossal nerve. Arch Neurol 41: 502–505
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Kamitani, H., Masuzawa, H., Kanazawa, I. et al. A combined extradural-posterior petrous and suboccipital approach to the jugular foramen tumours. Acta neurochir 126, 179–184 (1994). https://doi.org/10.1007/BF01476430
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DOI: https://doi.org/10.1007/BF01476430