Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Clinical and surgical significance of the jugular foramen anatomy: systematic review with meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Taprantzis Nikolaos, Chrysikos Dimosthenis, Shihada Amir, Piagkou Maria, Troupis Theodore
Аннотация
BACKGROUND: The jugular foramen, at the junction of the temporal and occipital bones, contains critical neurovascular structures. Variations such as high-riding bulbs, bony domes, and septations can influence clinical syndromes and complicate surgery. While some reviews address individual features, no meta-analysis has comprehensively evaluated jugular foramen morphology and its clinical and surgical significance.
METHODS: We systematically searched PubMed, Embase, Web of Science, and Scopus for studies reporting jugular foramen morphometry, including dome presence, septations, fossa depth, and high jugular bulbs. Pooled prevalence estimates were calculated using R programming software, with heterogeneity and risk of bias assessed via AQUA, Peter's, and Egger's tests.
RESULTS: Our meta-analysis revealed significant intercontinental and sex-related variations in jugular foramen morphology. African populations had fewer bilateral domes (20% vs. ∼54-55%), higher dome absence (53.7% vs. <13%), and larger AP diameters, while high-riding bulbs were more common in Asia (16.52%). Magnetic Resonance Imaging was associated with a significantly lower high jugular bulb prevalence, compared to osteological assessments and Computed Tomography-based techniques. Males showed slightly larger mediolateral dimensions, whereas females had a modestly higher incidence of high-riding bulbs (ratio 1.33). Bony septum analysis showed left partial septation as the most common pattern, with complete septations in 15.05% (right) and 12.11% (left) of individuals, indicating additional clinically relevant anatomical variation.
CONCLUSION: Anatomical variations of the jugular foramen-including asymmetry, dome morphology, high-riding bulbs, and septations-have direct clinical implications. They influence neurovascular compression, risk of hearing disturbances, tumor extension, and surgical planning for middle ear and skull base procedures. Recognition of these patterns is essential for safe operative navigation, minimizing intraoperative complications, and optimizing patient outcomes.
METHODS: We systematically searched PubMed, Embase, Web of Science, and Scopus for studies reporting jugular foramen morphometry, including dome presence, septations, fossa depth, and high jugular bulbs. Pooled prevalence estimates were calculated using R programming software, with heterogeneity and risk of bias assessed via AQUA, Peter's, and Egger's tests.
RESULTS: Our meta-analysis revealed significant intercontinental and sex-related variations in jugular foramen morphology. African populations had fewer bilateral domes (20% vs. ∼54-55%), higher dome absence (53.7% vs. <13%), and larger AP diameters, while high-riding bulbs were more common in Asia (16.52%). Magnetic Resonance Imaging was associated with a significantly lower high jugular bulb prevalence, compared to osteological assessments and Computed Tomography-based techniques. Males showed slightly larger mediolateral dimensions, whereas females had a modestly higher incidence of high-riding bulbs (ratio 1.33). Bony septum analysis showed left partial septation as the most common pattern, with complete septations in 15.05% (right) and 12.11% (left) of individuals, indicating additional clinically relevant anatomical variation.
CONCLUSION: Anatomical variations of the jugular foramen-including asymmetry, dome morphology, high-riding bulbs, and septations-have direct clinical implications. They influence neurovascular compression, risk of hearing disturbances, tumor extension, and surgical planning for middle ear and skull base procedures. Recognition of these patterns is essential for safe operative navigation, minimizing intraoperative complications, and optimizing patient outcomes.