Craniocervical Approach to the Jugular Foramen

We describe the craniocervical approach to the jugular foramen used at the University of Cincinnati. The surgical technique is divided into three parts: (A) cervical dissection, (B) cranial dissection, and (C) jugular foramen dissection. Each part is subdivided into its essential steps (Table 82-6), which are performed by the ENT surgeons and the neurosurgeons. As with all surgery of the skull base, we view these approaches as a series of building blocks, each of which is included or excluded according to the particular lesion upon which we are operating. In the true sense of skull base surgery, our approach to jugular foramen lesions is a collaborative effort between head and neck surgery, neurotology, neurosurgery, neuroradiology, and radiation oncology. Philosophically, our strategy is to control and isolate neurovascular structures proximally and distally. This strategy allows us to follow these structures from areas of intact normal anatomy to areas distorted by tumor, facilitating their dissection and preservation when possible.

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