Usefulness of Venous Reconstruction After Sigmid Sinus Resection on the Surgery for Tumor Around the Jugular Foramen

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We surgically treated 37 patients who had a tumor around the jugular foramen in our university over the past 8 years. The sigmoid sinus involved by the tumor was resected and occluded without reconstruction in 30 cases. Three to 8 years after the surgery, 4 patients were readmitted because of late complication secondary to sinus resection. Total sinus thrombosis was seen in 1 patient and dural arteriovenous fistula (AVF) of the affected lateral sinus in 3 patients. Pathological findings of the resected AVF and clinical course of the patients suggested strongly that these complications would be secondary retrograde extension of the thrombosis that occurred in the resected sinus rest.<BR>To prevent late complications such as delayed retrograde thrombotic extension and chronic intracranial hypertension due to venous congestion after sigmoid sinus resection in the surgery for tumor around the jugular foramen, we performed sinus circulation reconstruction with vein graft bypass in 7 recent cases. The saphenous vein was used as a graft and the bypass was performed between the lateral sinus and jugular vein (3 cases) or the sigmoid sinus and jugular vein (4 cases). In 5 cases the patency of the graft vein was comfirmed on the follow-up angiography performed 3 months after the surgery.<BR>Although because of the short follow-up periods we cannot say with certainty that the vein graft bypass after resection of the sigmoid sinus effectively prevents late complications we think that bypass with venous graft is a good strategy to prevent late complication after the sigmoid sinus resection.
The Japanese Society on Surgery for Cerebral Strokeの論文

Usefulness of Venous Reconstruction After Sigmid Sinus Resection on the Surgery for Tumor Around the Jugular Foramen

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