Anatomical corridors and quantitative spatial parameters of the jugular foramen: a computed tomography-based reference for skull base surgery

The jugular foramen (JF) is a complex skull base structure, and its high anatomical variability and deep location make surgical access challenging. The primary aim of this study was to establish standardized morphometric references for the JF and its adjacent landmarks to assist in the preoperative evaluation of lateral and posterior skull base approaches.

Computed tomography (CT) images of 200 adults were retrospectively analyzed using 3D-SLICER. Morphometric measurements of the JF and surrounding structures were performed in axial and 3D reconstructions. Anatomical variations, including septa and pneumatization, were recorded, along with side-to-side and sex-based comparisons.

JF diameter and area were significantly greater on the right (P < 0.01). Jugular process (JP) bone thickness increased significantly toward the sigmoid sinus. JP area ranged from 209.8 to 588.7 mm² and was significantly greater bilaterally in males (P < 0.01). The mastoid process-JP-styloid process (MP-JP-SP) triangle area ranged from 30.8 to 172.3 mm². The shortest distances from the JF (anterior/posterior ends) to the occipital condyle were 12.6 mm and 13.3 mm, respectively, both significantly greater in males (P < 0.01). Across 400 total sides, JP pneumatization was identified in 12 (3.0%) and septa in 28 (7.0%).

This study successfully provides a comprehensive morphometric framework for the JF region. These established baselines, particularly in the JP and MP-JP-SP triangle areas, serve as population-based reference data intended to support preoperative spatial mapping of complex neurovascular boundaries and anatomical orientation during skull base procedures, pending further anatomical and clinical validation.