Artikel
Morphometric analysis of the presigmoidal suprabulbar infralabyrinthine approach with neuronavigational assistance to the jugular foramen region – quantitative analysis of exposed area and surgical freedom
Morphometrische Analyse des neuronavigierten präsigmoidalen suprabulbaren infralabyrinthären Zugangs zum Foramen Jugulare: Quantitative Analyse des Zugangareals und der Manövrierbarkeit des Chirurgen
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: The navigated presigmoidal suprabulbar infralabyrinthine approach without rerouting of the fallopian canal is described as a suitable approach for tumors located at the intra -and supraforaminal region of the jugular foramen (JF). The aim of the anatomical study is to evaluate the surgical freedom and angle of attack with particular focus on defined target points.
Methods: The infralabyrinthine approach was performed on ten adult human cadaver heads (20 total sides). To calculate the values, the vector coordinates were registered image-guided.
Results: The exposed area was calculated at 51.1 ± SD 1.3 mm2, and the surgical freedom of exposed area at 18383.1 ± SD 567.8 mm2. The surgical freedom and angle of attack at the lateral and superolateral target points of the JF are significantly larger than at the medial and superomedial border.
Conclusion: The neuronavigated presigmoidal suprabulbar infralabyrinthine approach without rerouting of the facial nerve allows sufficient surgical freedom and angle of attack to intra -and supraforaminal jugular foramen tumors (JFTs). Compared with medially and superomedially located target points at the JF, the surgical freedom, the horizontal viewing angle and the vertical viewing angle of the surgeon are significantly larger at the lateral and superolateral target points. Especially, JFTs with lateral extension intra -and supraforaminal can be combined with the neuronavigated infralabyrinthine approach.