关键词: 颈静脉孔区, 　沟通性肿瘤, 　联合入路, 　寰椎横突, 　颈静脉突, 　解剖

Abstract:

Objective　To provide anatomical basis for the clinical application of communicating tumors in the jugular foramen region through comparing the combined far-lateral paracondylar-partial transcondylar approach with the combined infralabyrinthine-suboccipital retrosigmoid approach.　Methods The exposed areas of the jugular foramen region and the corresponding anatomic marks were compared by simulating these two kinds of combined approaches under microscope in 16 cadaveric adult heads; Meanwhile, the exposed status of the extracranial segment of jugular foramen region after removal of the atlas transverse process was observed.　Results　These two kinds of combined approaches can reveal the intracranial segment and limited extracranial segment of the jugular foramen region. The combined far-lateral paracondylar-partial transcondylar approach is superior to reveal the posteromedial area of jugular foramen,while the combined infralabyrinthine-suboccipital retrosigmoid approach is superior to reveal the posterolateral area of jugular foramen. The occipital condyle and jugular process are anatomical landmarks of the former. The stylomastoid foramen and jugular process are anatomical landmarks of the latter. Atlas transverse process resection can extend the exposure of extracranial segment of the jugular foramen region(retrostyloid parapharyngeal space).　Conclusions　With the aid of atlas transverse process resection, the combined far-lateral paracondylar-partial transcondylar approach is suitable for management of communicating tumors in the jugular foramen region whose major part was medial to the foramen, while the combined infralabyrinthine-suboccipital retrosigmoid approach is more suitable for management of communicating tumors in the jugular foramen region whose major part was lateral to the foramen.

Key words:  , Jugular foramen region；　Communicating tumors；　Combined approaches；　Atlas transverse process；　Jugular process；　Anatomy