Endoscopic Paramaxillary Approach to the Hypoglossal Canal and Jugular Foramen

Introduction: Obtaining adequate access to the hypoglossal canal and jugular foramen poses a challenge to the surgeon due to its location. Open surgical approaches are commonly employed to access this region; however, this involves significant bony removal, external incisions, and retraction of brain with the potential for greater morbidity. The purpose of this study is to demonstrate the role of a novel endoscopic approach to access the regions of the hypoglossal canal and jugular foramen and clearly delineate the relevant anatomy. We describe in detail an “endoscopic paramaxillary approach,” which is a transoral approach that provides a direct, rapid, and safe approach through the infratemporal fossa and parapharyngeal space to access the hypoglossal canal and jugular foramen.