Glomus Jugulare - ITF Type - A Approach
Glomus Jugulare - ITF Type - A Approac
Fig.1 Post Auricular Incision From Temporal Region To Cricoid
Fig.2 Skin flap was raised superficial to temporalis and sternomastoid muscles. Anteriorly based myoperiosteal flap was raised over the mastoid (for blind closure).
Fig.3 EAC is divided at the bony and cartilagenous junction. The skin was dissected off the cartilage (for blind closure)
Fig.4 Elevated skin of the cartilagenous canal was everted and closed (first layer of blind sac)
Fig.5 Anteriorly based myoperiosteal layer was rotated (arrow) and sutured to the cartilage of the canal (as a second layer of blind sac closure)
Fig.6 Neck is dissected and ECA, ICA, IJV, and cranial nerves VII, X, XI & XII are exposed.
Fig.7 Subtotal petrosectomy done. Facial nerve is decompressed from geniculate ganglion to its bifurcation in the parotid gland.
Fig.8 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.
Fig.9 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.
Fig.10 MR angio shows no blood flow on the side of tumour (yellow arrow). Tumour can grow inside the lumen of the jugular bulb and occlude it completely.
Fig.11 Picture shows tumour inside IJV.
Fig.12 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.
Fig.13 Closure. Dead space is filled with free fat.
Fig.14 Closure. The Temporalis muscle is rotated and sutured to the sternomastoid muscle.
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)
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The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)