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Skull base surgery. 1994 January; 4(1): 37–40.
PMCID: PMC1656462

Management of the Jugular Bulb During Lateral Skull Base Surgery


The intraoperative management of a patent jugular bulb presents a formidable challenge during the treatment of lateral skull base lesions. Whether to preserve, partially occlude, or completely sacrifice this critical structure is a decision best made following a multifactorial analysis of preoperative clinicoradiographic data, tumor histopathology, and intraoperative findings. Twenty-six patients with tumors requiring dissection near a patent jugular bulb were reviewed. Ten patients had superior neck tumors, nine had primary temporal bone lesions, and seven presented with recurrent parotid malignancies. The most common clinical manifestations were headache and vocal cord paralysis and the most significant radiographic finding was the presence of a mass at the styloid base. Jugular bulb patency was preserved in six patients, partially maintained in seven, and was sacrificed in 13 individuals. This article focuses on the clinicoradiographic findings in patients with neoplastic jugular foramen encroachment, but preserved jugular blood flow. Surgical technique will be detailed through selected case presentations and the management of lower cranial nerve injuries will be reviewed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Graham MD. The jugular bulb: its anatomic and clinical considerations in contemporary otology. Laryngoscope. 1977 Jan;87(1):105–125. [PubMed]
  • Daniels DL, Williams AL, Haughton VM. Jugular foramen: anatomic and computed tomographic study. AJR Am J Roentgenol. 1984 Jan;142(1):153–158. [PubMed]
  • Gacek RR. Pathology of jugular foramen neurofibroma. Ann Otol Rhinol Laryngol. 1983 Mar-Apr;92(2 Pt 1):128–133. [PubMed]
  • Call WH, Pulec JL. Neurilemoma of the jugular foramen. Transmastoid removal. Ann Otol Rhinol Laryngol. 1978 May-Jun;87(3 Pt 1):313–317. [PubMed]
  • Kaye AH, Hahn JF, Kinney SE, Hardy RW, Jr, Bay JW. Jugular foramen schwannomas. J Neurosurg. 1984 May;60(5):1045–1053. [PubMed]
  • Goldenberg RA, Gardner G. Tumors of the jugular foramen: surgical preservation of neural function. Otolaryngol Head Neck Surg. 1991 Jan;104(1):129–129. [PubMed]
  • Lo WW, Solti-Bohman LG. High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology. 1984 Mar;150(3):743–747. [PubMed]

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