Figure 11.3 The class C tumor originates in the dome of the jugular bulb and destroys the infralabyrinthine compartment. The tumor may spread in the following directions: interiorly, along the internal jugular vein and cranial nerves IX—XII; suPeriorly, towards the otic caPsule and the internal auditory canal; Posteriorly, into the sigmoid sinus; anteriorly, to the internal carotid artery; more medially, to the petrous apex and the cavernous sinus; or laterally, to the hyPotymPanum and middle ear. Class C tumors are further subdivided according to the degree of erosion of the carotid canal. The C1 tumor erodes the carotid foramen without involvement of the carotid artery.

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