The transcondylar approach to the jugular foramen: a comparative anatomic study

Area of Science:

• Neurosurgery
• Anatomy
• Surgical Approaches

Background:

• Standard jugular foramen neurosurgical approaches have limitations in accessing the infratemporal fossa.
• Existing neurootologic exposures offer infratemporal access but compromise posterior fossa exposure, risking hearing and facial nerve deficits.

Purpose of the Study:

• To evaluate the efficacy of the transcondylar approach for jugular foramen exposure.
• To compare the transcondylar approach with standard methods for anatomical and morphometric advantages.

Main Methods:

• Utilized cadaver specimens to perform the transcondylar approach, involving a retromastoid incision extended into the neck.
• Opened the transverse foramen of the atlas, transposed the vertebral artery, and performed a suboccipital craniectomy with occipital condyle resection.
• Identified cranial nerves 9-12 extracranially and traced them proximally to the brain stem.

Main Results:

• The transcondylar approach provided favorable exposure of the jugular foramen region and infratemporal fossa.
• Morphometric and anatomical comparisons demonstrated advantages over three standard approaches.
• Preservation of auditory and facial nerve function was noted.

Conclusions:

• The transcondylar approach offers a viable alternative for jugular foramen surgery.
• This technique provides excellent exposure while preserving critical neurological function.
• It is particularly advantageous for single-stage tumor resections in this region.