Anatomical study of jugular foramen in the neck

Abstract Introduction The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy. Objective To study the anatomy of the jugular foramen, internal jugular vein and glossopharyngeal, vagus and accessory nerves, and to identify the anatomical relationships among these structures in the jugular foramen region and lateral-pharyngeal space. Methods A total of 60 sides of 30 non-embalmed cadavers were examined few hours after death. The diameters of the jugular foramen and its anatomical relationships were analyzed. Results The diameters of the jugular foramen and internal jugular vein were greater on the right side in most studied specimens. The inferior petrosal sinus ended in the internal jugular vein up to 40 mm below the jugular foramen; in 5% of cases. The glossopharyngeal nerve exhibited an intimate anatomical relationship with the styloglossus muscle after exiting the skull, and the vagal nerve had a similar relationship with the hypoglossal nerve. The accessory nerve passed around the internal jugular vein via its anterior wall in 71.7% of cadavers. Conclusion Anatomical variations were found in the dimensions of the jugular foramen and the internal jugular vein, which were larger in size on the right side of most studied bodies; variations also occurred in the trajectory and anatomical relationships of the nerves. The petrosal sinus can join the internal jugular vein below the foramen.

摘要：颈静脉孔（jugular foramen）的解剖结构复杂，使得该区域的外科手术操作精细且难度颇高。随着外科技术的进步，针对颈静脉孔区的手术入路日益增多，这对该区域解剖知识的精细化掌握提出了更高要求。
目的：本研究旨在探讨颈静脉孔、颈内静脉（internal jugular vein）、舌咽神经（glossopharyngeal nerve）、迷走神经（vagus nerve）及副神经（accessory nerve）的解剖结构，并明确上述结构在颈静脉孔区及咽旁间隙（lateral-pharyngeal space）中的解剖毗邻关系。
方法：本研究共纳入30具无防腐处理尸体的60侧标本，于死后数小时内进行解剖观察，测量颈静脉孔的径线并分析其解剖毗邻关系。
结果：多数研究标本的右侧颈静脉孔及颈内静脉径线更大。5%的标本中，下岩窦（inferior petrosal sinus）的汇入点位于颈静脉孔下方至多40mm处的颈内静脉。舌咽神经出颅后与茎突舌肌（styloglossus muscle）存在紧密的解剖毗邻关系，迷走神经则与舌下神经（hypoglossal nerve）呈现类似的毗邻关系。71.7%的尸体标本中，副神经经颈内静脉前壁绕行。
结论：本研究发现颈静脉孔与颈内静脉的径线存在解剖变异，多数标本的右侧结构径线更大；同时各神经的走行路径及解剖毗邻关系也存在变异。下岩窦可于颈静脉孔下方汇入颈内静脉。