课件：颈静脉孔区解剖.ppt

operative view of the transcond-ylar fossa approach 1:glossopharyngeal nerve ;2: the PICA ; 3: vagal nerve;4: accessory nerve ; 5: the vertebral artery ; 6: posterior condylar emissary vein; 7: AICA ; 8:choroid plexus. Surgical technique of exposing the neural component of the jugular foramen A: Normal view of the jugular foramen. Also shown are Cranial Nerves V, VII, and VIII. B: An intracranial meningioma with jugular foramen involvement is depicted. the tumor is posterior to the nerve roots (the most favorable situation). C: Drilling of the neural component of the jugular foramen is performed. D:Tumor within the jugular foramen can then be microdissected out. transcondylar approach Angle of surgical approach pre, ASA to clivus before OC resection post, ASA to JT after OC resection. the far lateral transcondylar exposure was 17 ± 1 mm. transcondylar approach，the jugular tubercle obstructs the anterior portion of the PICA aneurysm. B ：gentle retraction of the spinal accessory nerve revealing the neck of the aneurysm, which is covered partially by the jugular tubercle. C： the dura covering the jugular tubercle is incised and reflected posterior before drilling. D ：drilling jugular tubercle, improved exposure of the anterior aspect of the aneurysm. The suction tip is used to retract and protect the spinal accessory nerve. E ： clip the aneurysm neck, with improved visualization and after reduction of the jugular tubercle. CI , continuous irrigation; JT , jugular tubercle; VA , vertebral artery THANK YOU SUCCESS * * 可编辑 sigmoid sinus descends in the sigmoid sulcus , sharp anterior turn to enter the jugular foramen. The jugular bulb extends upward under the petrous temporal bone toward the internal acoustic meatus nerves penetrate the dura on the medial side of the intrajugular process, intrajugular ridge extends forward along the medial side of the jugular bulb glossopharyngeal nerve passes forward along the medial side of the intrajugular ridg