[The retro-auricular, transmastoid, infralabyrinth approach. A simple route for excision of tumors of the jugular foramen].
BACKGROUND
The jugular foramen is a complex area of the skull base. Its contents, the anatomical relationships in the region, and its location at the skull base, are responsible for problematic surgical approaches. The classical infratemporal surgical routes remain complex and difficult to perform. The lateral approach through a mastoidectomy is almost always associated with an anterior transposition of the facial nerve although that transposition is usually unnecessary.


METHODS
Progressive drilling along the sinusojugular axis, inferior to the labyrinth and medial to the third portion of the facial nerve, combined with a simple neck dissection, allows the surgeon to nicely expose the jugular foramen. The surgical procedure is described, following a brief anatomical reminder of the essential relationships in the area. A clinical observation is used to illustrate the purpose.


RESULTS
Most schwannomas of lower cranial nerves and small glomus jugulare tumors should be resected using this approach, which is a simplified lateral approach, without post operative facial palsy or cophosis.


CONCLUSIONS
The infralabyrinthine approach is a simple way to expose the jugular foramen region compared with infratemporal complex and time-consuming approaches.
Service de Neurochirurgie (Pr Guy), CHU, Angers.
H D
HD
Fournier
L
L
Laccoureye
P
P
Mercier
D000328:Adult; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D009333:Neck / Q000601:surgery; D009442:Neurilemmoma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery*
La voie rétro-auriculaire trans-mastoïdienne infra-labyrinthique. Un abord simple pour l'exérèse des tumeurs du foramen jugulaire.