Transcervical transmastoid approach to lesions of the jugular bulb.

Traditional approaches to the jugular bulb principally designed for the extirpation of tumors of the skull base, such as chemodectomas, require a transmastoid approach with transposition of the facial nerve. Such manipulation of the nerve commonly leads to some postoperative impairment. The transmastoid transcervical approach, in which the patient's head is acutely flexed forward, the skull base muscles are separated from their origins, and a retrofacial dissection is performed, permits access to the jugular bulb between the undersurface of the skull and C-1.