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Titolo:
Jugular foramen: Microscopic anatomic features and implications for neuralpreservation with reference to glomus tumors involving the temporal bone
Autore:
Sen, C; Hague, K; Kacchara, R; Jenkins, A; Das, S; Catalano, P;
Indirizzi:
Mt Sinai Med Ctr, Dept Neurosurg, New York, NY 10029 USA Mt Sinai Med CtrNew York NY USA 10029 Neurosurg, New York, NY 10029 USA Mt Sinai Med Ctr, Dept Neuropathol, New York, NY 10029 USA Mt Sinai Med Ctr New York NY USA 10029 europathol, New York, NY 10029 USA Sree Chitra Tirunal Inst Med Sci & Technol, Dept Neurosurg, Thiruvananthapuram, Kerala, India Sree Chitra Tirunal Inst Med Sci & Technol Thiruvananthapuram Kerala India Lahey Clin, Dept Otolaryngol, Burlington, MA USA Lahey Clin Burlington MAUSA Clin, Dept Otolaryngol, Burlington, MA USA
Titolo Testata:
NEUROSURGERY
fascicolo: 4, volume: 48, anno: 2001,
pagine: 838 - 847
SICI:
0148-396X(200104)48:4<838:JFMAFA>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIGH-RESOLUTION CT; MICROSURGICAL ANATOMY; SURGERY; NERVE; NEURILEMMOMA;
Keywords:
caudal cranial nerves; glomus tumor; jugular foramen; temporal bone;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Sen, C Columbia Univ, St Lukes Roosevelt Hosp Ctr, Dept Neurosurg, 425 W 59th St,Suite 4F, New York, NY 10019 USA Columbia Univ 425 W 59th St,Suite 4F New York NY USA 10019 0019 USA
Citazione:
C. Sen et al., "Jugular foramen: Microscopic anatomic features and implications for neuralpreservation with reference to glomus tumors involving the temporal bone", NEUROSURGER, 48(4), 2001, pp. 838-847

Abstract

OBJECTIVE: Our goals were to study the normal histological features of thejugular foramen, compare them with the histopathological features of glomus tumors involving the temporal bone, and thus provide insight into the surgical management of these tumors with respect to cranial nerve function. METHODS: Ten jugular foramen blocks were obtained from five human cadaversafter removal of the brain. Microscopic studies of these blocks were performed, with particular attention to fibrous or bony compartmentalization of the jugular foramen, the relationships of the caudal cranial nerves to the jugular bulb/jugular vein and internal carotid artery, and the fascicular structures of the nerves. In addition, we studied the histopathological features of 11 glomus tumors involving the temporal bone (10 patients), with respect to nerve invasion, associated fibrosis, and carotid artery adventitial invasion. RESULTS: A dural septum separating the IXth cranial nerve from the fascicles of Cranial Nerves X and XI, at the intracranial opening, was noted. Onlytwo specimens, however, had a septum tone bony and one fibrous) producing internal compartmentalization of the jugular foramen. The cranial nerves remained fasciculated within the foramen, with the vagus nerve containing multiple fascicles and the glossopharyngeal and accessory nerves containing one and two fascicles, respectively. All of these nerve fascicles lay medial to the superior jugular bulb, with the IXth cranial nerve located anteriorly and the XIth cranial nerve posteriorly. All nerve fascicles had separate connective tissue sheaths. A dense connective tissue sheath was always present between the IXth cranial nerve and the internal carotid artery, at the level of the carotid canal. The inferior petrosal sinus was present betweenthe IXth and Xth cranial nerves, as single or multiple venous channels. The glomus tumors infiltrated between the cranial nerve fascicles and inside the perineurium. They also produced reactive fibrosis. In one patient, in whom the internal carotid artery was also excised, the tumor invaded the adventitia. CONCLUSION: Within the jugular foramen, the cranial nerves lie anteromedial to the jugular bulb and maintain a multifascicular histoarchitecture (particularly the Xth cranial nerve). Glomus tumors of the temporal bone can invade the cranial nerve fascicles, and infiltration of these nerves can occur despite normal function. In these situations, total resection may not be possible without sacrifice of these nerves.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 08:52:12