Surgical approaches to jugular foramen schwannomas: An anatomic study

Background. The variety of surgical approaches to jugular schwannomas makes selection of an approach difficult. The purpose of this study was to define the anatomic elements of these approaches. Methods. Ten adult cadaveric heads were examined. Results. There are lateral, posterior, and anterior routes that access various parts of the jugular foramen. Removal of the jugular process of the occipital bone provides access to the posterior aspect of the foramen, the infralabyrinthine mastoidectomy provides access to the lateral edge and dome of the jugular bulb, and the preauricular approaches provide access to the anterior margin of the bulb and foramen. Additions to these approaches may include cervical and vertebral artery exposure, facial nerve transposition, foramen magnum exposure, and external canal and condylar resection. Conclusion. An understanding of the anatomy of the jugular foramen is crucial in achieving total tumor removal while minimizing risk. (c) 2015 Wiley Periodicals, Inc.