Analysis of Jugular Foramen Exposure in the Fallopian Bridge Technique

ABSTRACT

Objective: To analyze the exposure of the jugular foramen afforded by the fallopian bridge technique. Method: The jugular foramen exposure was obtained using the jugular foramen approach combined with the fallopian bridge technique. We applied this technique using 10 temporal bone specimens at a tertiary referral center. The exposure was assessed by means of depth of the dissection field and two separate dissection spaces that were created anteriorly and posteriorly to the facial nerve. Anteroposterior and superoinferior dimensions of the anterior dissection space were 4.4 ± 1.03 mm and 6.3 ± 2.49 mm, respectively. The superoinferior and anteroposterior dimensions of the posterior dissection space were 11.7 ± 2.08 mm and 8.0 ± 2.95 mm, respectively. The depth of the first dissection field was 8.2 ± 2.11 mm. After perforating the jugular bulb, the depth of the second dissection field was 16.0 ± 1.60 mm. Results: The anterior dissection space serves only as an additional visualization space for anatomical orientation to the jugular bulb. Tumor dissection is to be accomplished mainly through the posterior dissection space. Conclusion: The fallopian bridge technique should be added to surgical armamentarium for the jugular foramen tumors confined only to the jugular fossa or tumors with middle ear extension.

Jugular foramen - fallopian bridge technique - facial nerve - infratemporal fossa approach - infralabyrinthine tumors

REFERENCES

• 1 Martin C, Prades J M. Removal of selected infralabyrinthine lesions without facial nerve mobilization.  Skull Base Surg. 1992;  2 220-226
• 2 Maniglia A J, Sprecher R C, Megerian C A, Lanzieri C. Inferior mastoidectomy-hypotympanic approach for surgical removal of glomus jugulare tumors: an anatomical and radiologic study emphasizing distances between critical structures.  Laryngoscope. 1992;  102 407-414
• 3 Pensak M L, Jackler R K. Removal of jugular foramen tumors: the fallopian bridge technique.  Otolaryngol Head Neck Surg. 1997;  117 586-591
• 4 Fisch U. Infratemporal fossa approach for glomus tumors of the temporal bone.  Ann Otol Rhinol Laryngol. 1982;  91 474-479
• 5 Von Doersten P G, Jackler R K. Anterior facial nerve rerouting in cranial base surgery: a comparison of three techniques.  Otolaryngol Head Neck Surg. 1996;  115 82-88