Endoluminal Sigmoid Sinus Occlusion During Jugular Foramen Tumor Surgery: Novel Technique, Operative Nuances, and Clinical Experience With 33 Patients.

Autor:	Castillo AL; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA.; Department of Neurosurgery, Antonio Lenin Fonseca Hospital, Managua , Nicaragua., Tang OY; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA., Gad SN; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA., Park RCW; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA.; Cooperman Barnabas Medical Center, RWJ Barnabas Health, Livingston , New Jersey , USA., Ying YM; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA.; Cooperman Barnabas Medical Center, RWJ Barnabas Health, Livingston , New Jersey , USA., Jyung RW; Cooperman Barnabas Medical Center, RWJ Barnabas Health, Livingston , New Jersey , USA., Liu JK; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA.; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark , New Jersey , USA.; Cooperman Barnabas Medical Center, RWJ Barnabas Health, Livingston , New Jersey , USA.; Skull Base Institute of New Jersey, Neurosurgeons of New Jersey, NYU Langone Neurosurgery Network, Livingston, New Jersey , USA.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Oct 01; Vol. 27 (4), pp. 491-499. Date of Electronic Publication: 2024 May 16.
DOI:	10.1227/ons.0000000000001165
Abstrakt:	Background and Importance: Surgery of jugular foramen tumors (JFTs) often requires vascular control by means of ligating the internal jugular vein and sigmoid sinus (SS) to allow intrabulbar access. Occlusion of the SS traditionally involves presigmoid and retrosigmoid durotomies allowing introduction of ligature devices, predisposing to cerebrospinal fluid (CSF) leakage and pseudomeningoceles. We describe a simple and novel endoluminal sigmoid sinus occlusion (ESSO) technique with Gelfoam that is entirely extradural. Clinical Presentation: An extended anterolateral infralabyrinthine approach with ESSO was performed in 33 patients with JFTs. After ligating the internal jugular vein, the SS is opened and Gelfoam is placed endoluminally into the proximal SS. Care is taken to avoid occlusion of the venous outflow of the vein of Labbe to avoid temporal lobe venous infarction. Hemostatic gelatin matrix is injected distally to stop venous backflow from the inferior petrosal sinus. The jugular venous system is isolated, and the outer jugular wall can be opened to expose the JFT for resection. There were no complications of temporal lobe venous infarction or postoperative hematoma observed. Four patients with intradural tumor extension developed pseudomeningoceles. For patients with purely extradural JFTs, none developed postoperative incisional CSF leaks and one had pseudomeningocele. Conclusion: This ESSO technique is fast and effective, permitting occlusion of the SS during JFT surgery. It has the advantage of being entirely extradural, avoiding durotomy which can result in postoperative CSF leak. It is important to keep the Gelfoam distal to the transverse-sigmoid junction to avoid occlusion of the vein of Labbe inlet and temporal lobe venous infarction. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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