Transsigmoid and extreme lateral approaches for removal of jugular foramen tumors

Abstract

Neoplasms arising in the jugular foramen may involve the posterior fossa, skull base, and cervical region. The infratemporal approach allows single-stage removal of tumor involving the posterior fossa, jugular foramen, and cervical region. The transient facial palsy and permanent conductive hearing loss associated with this approach led Mann et al to develop the transsigmoid approach. This technique, which combines the suboccipital and retrolabyrinthine approaches, provides access similar to the infratemporal fossa approach without rerouting the facial nerve or obliterating the middle ear. The extreme lateral approach is an inferior extension of the transsigmoid approach and may be used for jugular foramen lesions that extend inferiorly to the foramen magnum. The surgical technique and use of these approaches are discussed. Neoplasms arising in the jugular foramen may involve the posterior fossa, skull base, and cervical region. The infratemporal approach allows single-stage removal of tumor involving the posterior fossa, jugular foramen, and cervical region. The transient facial palsy and permanent conductive hearing loss associated with this approach led Mann et al to develop the transsigmoid approach. This technique, which combines the suboccipital and retrolabyrinthine approaches, provides access similar to the infratemporal fossa approach without rerouting the facial nerve or obliterating the middle ear. The extreme lateral approach is an inferior extension of the transsigmoid approach and may be used for jugular foramen lesions that extend inferiorly to the foramen magnum. The surgical technique and use of these approaches are discussed.