37 Infratemporal fossa approach to jugular foramen Infratemporal Fossa Approach to the Jugular Foramen

This chapter will give the reader full description on the infratemporal retroauricular transmastoid approach to skull base lesions, especially in relation with the jugular foramen. We describe the step-by-step technique to deal with difficult lesions such as the most common one at this region, the glomus jugulare tumors. They account for 80% of the jugular foramen tumors and are the second most common head and neck paragangliomas. Rosenwasser was the first surgeon to attempt total resection and described it in 1945. Fisch evolved the technique and effectively classified this pathology into types A, B, C, and D. Our special interest are the advanced types C and D (the latter with intradural extension). Here we will demonstrate our experience on how do we do this stepwise dissections without mobilizing the facial nerve from its mastoid canal, remembering all the special steps to deal with in this highly vascularized pathology.