Clinical and surgical significance of the jugular foramen anatomy: systematic review with meta-analysis

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.