Accessory Foramina Presence Significantly Narrows the Jugular Foramen: Anatomical Study with Potential Neurosurgical Significance

George Triantafyllou; Ioannis Paschopoulos; Panagiotis Papadopoulos; Sabino Luzzi; Renato Galzio; Łukasz Olewnik; George Tsakotos; Nicol Zielinska; Piotr Łabętowicz; Maria Piagkou

doi:10.1055/a-2587-5982

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base
DOI: 10.1055/a-2587-5982

Original Article

Accessory Foramina Presence Significantly Narrows the Jugular Foramen: Anatomical Study with Potential Neurosurgical Significance

George Triantafyllou

¹Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece

,

Ioannis Paschopoulos

¹Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece

,

Panagiotis Papadopoulos

²Department of Neurosurgery, General Hospital of Nikaia-Piraeus, Athens, Greece

,

Sabino Luzzi

³Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

,

Renato Galzio

³Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

,

Łukasz Olewnik

⁴Department of Clinical Anatomy, Masovian Academy in Płock, Płock, Poland

,

George Tsakotos

¹Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece

,

Nicol Zielinska

⁴Department of Clinical Anatomy, Masovian Academy in Płock, Płock, Poland

,

Piotr Łabętowicz

⁴Department of Clinical Anatomy, Masovian Academy in Płock, Płock, Poland

,

Maria Piagkou

¹Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece

› Author Affiliations

Abstract

Introduction

The jugular foramen (JF) is a critical anatomical structure that houses the lower cranial nerves (IX, X, and XI), making it a key focus in neurosurgical procedures. Variations, such as ossified dural septations within the JF, can significantly impact surgical outcomes. The present study investigates the incidence and impact of these ossifications on JF morphometry, providing insights crucial for surgical planning and execution.

Materials

We analyzed bilaterally 120 adult dried skulls to assess the presence of accessory foramina (AF), proposing that these represent ossified dural septations. Morphometric measurements of the JF, including height and width, were taken in both cases with and without AF with the use of digital caliper. A thorough literature review was conducted to correlate the findings with clinical implications, and statistical analyses were used to determine significant morphological differences.

Results

A complete AF was identified in 2.92% of skulls and an incomplete one in 0.42%. Ossified dural septations were associated with significantly reduced JF height and width. This reduction may hinder intraoperative manipulation, especially of the lower cranial nerves, increasing the potential for complications.

Conclusion

The findings underscore the need to recognize JF variants, especially ossified septations, in neurosurgical practice. These variants can complicate surgical approaches to the skull base, highlighting the need for careful preoperative assessment. Future studies are warranted to explore the clinical ramifications of these findings, particularly to patient outcomes in skull base surgeries.

Keywords

accessory foramen - infratemporal fossa approach - jugular foramen - variation - neurosurgical anatomy - ossification - dural septation - skull base - surgical planning

Full Text

References

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