J Neurol Surg B Skull Base 2017; 78(S 01): S1-S156
DOI: 10.1055/s-0037-1600722
Poster Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Microsurgical Anatomy of the Jugular Process: Cadaveric and Radiological Study

Noritaka Komune
1   Department of Otorhinolaryngology, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan
,
Satoshi Matsuo
2   Department of Neurosurgery, Kyushu Central Hospital, Fukuoka, Japan
,
Miki Koichi
3   Department of Neurosurgery, Fukuoka University, Graduate School of Medical Sciences, Fukuoka, Japan
,
Albert L. Rhoton Jr
4   Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
02 March 2017 (online)

 

Background: The jugular process forms the posterior border of the jugular foramen. This process is the critical structures for the access to the jugular foramen. However, the microsurgical anatomy of this structure has not been described well in most modern text.

Object: The objective is to elucidate the microsurgical anatomy of the jugular process through cadaveric dissection and to investigate the radiological feature of the process.

Materials and Methods: This is a cadaveric and radiological study. Five adult cadaveric specimens and a dry skull were examined to expose the detailed anatomy of the jugular process and its surrounding structures. Thirty one computed tomography angiography images (62 sides) were examined to investigate the relationships between the course of the sigmoid sinus and the morphological feature of the process.

Results: Cadaveric study shows that the jugular process is closely related to the sigmoid sinus, jugular bulb, rectus capitis lateralis muscle, and lateral atlantooccipital ligament, and the process is a key landmark for the accessing of the jugular foramen both from posterior and lateral. Radiographic study shows the morphological features of this process. Nine out of 62 sigmoid sinuses protrude inferiorly into the jugular process. The jugular bulb is categorized into two types: the sloped type and the morphologically bulbed type. The process located below the sigmoid sinus in the latter tends to have a steeper angle, thus proving more difficult to remove from the posterior aspect for the exposure of the posterior wall of the jugular foramen.

Conclusion: The jugular process forms the posterior border of the jugular foramen. The resection of the jugular process is crucial in open the jugular foramen from the posterior and lateral aspect. The detailed knowledge of this structure is essential to approach the jugular foramen. The precise understanding the microsurgical anatomy of the process and preoperative evaluation of the relationships between the process and the sigmoid sinus makes surgical access to the jugular foramen safe and accurate.