Tekdemir I, Tuccar E, Aslan A, Elhan A, Deda H, Ciftci E, Akyar S
Anatomy Department of Ankara University School of Medicine, Turkey.
Surg Neurol. 1998 Dec;50(6):557-62. doi: 10.1016/s0090-3019(98)00048-2.
Advances in microsurgical techniques made possible the removal of advanced jugular foramen (JF) lesions, which once had been accepted as unoperable. However, successful surgery requires detailed knowledge of the JF anatomy.
Sixteen jugular foramina in eight formalin-preserved adult cadavers were scanned with axial and coronal high resolution computed tomography (HRCT) prior to dissection. After craniectomy and removal of brain tissue, the relationships of the neurovascular structures in the JF were determined by drilling the temporal bones from superior to inferior on planes parallel to the skull base.
No bony partition of the JF was observed. A dural band consistently divided the JF into two parts. Anterior to it was the glossopharyngeal nerve (IX) while the vagus (X) and accessory (XI) nerves were located posteriorly. There was a notch in which the IX nerve entered the JF. It was also identified on the CT scans and defined as the glossopharyngeal recess. The IX nerve made a genu within the JF in all specimens. Then, it ran inferiorly through a bony canal in three specimens (18.75%), and through an incomplete bony canal in two (12.5%), which were also defined on the CT images. The inferior petrosal sinus ran through a sulcus anteromedial to the glossopharyngeal recess. The posterior meningeal artery was found to be located between the X and XI nerves within the JF.
This study revealed a complex and highly variable pattern of the relationships of the neurovascular structures in the JF, and their HRCT images correlated well with the anatomic microdissections.
显微外科技术的进步使得切除曾经被认为无法手术的晚期颈静脉孔（JF）病变成为可能。然而，成功的手术需要对颈静脉孔解剖结构有详细的了解。
在解剖前，对8具用福尔马林保存的成年尸体的16个颈静脉孔进行了轴向和冠状高分辨率计算机断层扫描（HRCT）。在颅骨切除和脑组织去除后，通过在与颅底平行的平面上从上方到下方钻颞骨来确定颈静脉孔内神经血管结构的关系。
未观察到颈静脉孔的骨性分隔。一条硬膜带始终将颈静脉孔分为两部分。其前方是舌咽神经（IX），而迷走神经（X）和副神经（XI）位于后方。有一个切迹，IX神经由此进入颈静脉孔。在CT扫描上也识别出了该切迹，并将其定义为舌咽隐窝。在所有标本中，IX神经在颈静脉孔内形成一个膝状弯曲。然后，在3个标本（18.75%）中，它向下穿过一个骨性管道，在2个标本（12.5%）中穿过一个不完全的骨性管道，这些在CT图像上也有显示。岩下窦穿过舌咽隐窝前内侧的一条沟。发现脑膜后动脉位于颈静脉孔内X和XI神经之间。
本研究揭示了颈静脉孔内神经血管结构关系的复杂且高度可变的模式，其HRCT图像与解剖显微解剖结果相关性良好。
