BACKGROUND: Mastoid emissary vein is especially important from the neurosurgical point of view, because it is located in variable number in the area of the occipitomastoid suture and it can become a source of significant bleeding in surgical approaches through the mastoid process, especially in retrosigmoid craniotomy, which is used for approaches to pathologies localized in the cerebellopontine angle. Ideal imaging method for diagnosis of these neglected structures when planning a surgical approach is high-resolution computed tomography. The aim of this work was to provide detailed information about this issue. METHODS: We studied a group of 295 skulls obtained from collections of five anatomy departments and the National Museum. Both quantitative and qualitative parameters of the mastoid foramen were evaluated depending on side of appearance and gender. Individual distances of the mastoid foramen from clearly defined surface landmarks (asterion, apex of mastoid process, foramen magnum) and other anatomical structures closely related to this issue (width of groove for sigmoid sinus, diameters of internal and external openings of mastoid foramen) were statistically processed. RESULTS: The most frequently represented type of the mastoid foramen is type II by Louis (41.2%). The differences between right and left sides were not statistically significant. In men there was a higher number of openings on the right side and in qualitative parameters the type III and IV predominated, whereas in women the types I and II were more frequent. In men, greater distances from the mastoid foramen were observed when evaluating qualitative parameters for defined surface landmarks. Mean size of the external opening diameter was 1.3 mm; however, several openings measured up to 7 mm. CONCLUSIONS: Despite excellent knowledge of anatomy, however, good pre-operative examination using imaging methods and mastering of microsurgical techniques create the base for successful treatment of pathological structures in these anatomically complex areas.
- MeSH
- foramen magnum anatomie a histologie diagnostické zobrazování chirurgie MeSH
- kraniotomie škodlivé účinky metody MeSH
- lidé MeSH
- mostomozečkový úhel anatomie a histologie diagnostické zobrazování chirurgie MeSH
- pooperační komplikace prevence a kontrola MeSH
- processus mastoideus anatomie a histologie diagnostické zobrazování chirurgie MeSH
- venae jugulares anatomie a histologie diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Poloha, velikost i tvar jugulárního bulbu (JB) je velmi variabilní. Vysoká poloha JB může být vzácně zdrojem klinických symptomů.Tato poloha všakmůžebýt častěji zdrojemproblémů nejen při otochirurgických operacích, ale i při laterálních a posterolaterálních transtemporálních přístupech v chirurgii lební baze. Autoři se zabývají diskusí o vlastní definici vysokého JB a preferují z klinického i rentgenologického hlediska jako nejlepší pro korelaci posuzování jeho polohy vztah k meatus acusticus internus (MAI). Svoje názory prezentují na morfometrické analýze vlastního souboru 50 lebních bazí. Vysoká poloha bulbu byla nalezena v 15 % a extrémně vysoká ve 3 %. V souboru vysokých JB dominuje pravá strana a ženské pohlaví. Článek také diskutuje možnosti diagnostiky polohy JB a komplikace spojené s jeho operačním poraněním.
The jugular bulb (JB) varies widely in position, size and shape. A high position of the jugular bulb may rarely lead to clinical symptoms. This position is may more often lead to dificulties not only during otosurgical operations, but also during lateral and posterolateral transtemporal approaches in skull base surgery. The authors discuss the definition of high jugular bulb and prefer from the roentgenological and clinical point of view the bulb’s position in relation to the meatus acusticus internus as the best for evaluation. The authors’ opinions are presented on the analysis of a group of 50 skull bases. There were 15% high positions of the bulb and 3% extreme by high. The right side and female gender dominate in the group of high jugular bulbs. Article also discusses the diagnostics of JB position and complications associated with its damage during surgery.
