Endoscopic-Assisted Transcervical Transparotid Approach to the Jugular Foramen Region

Abstract The transcervical transparotid approach was developed for the management of lesions in the parapharyngeal space, while its application for addressing lesions at the jugular foramen region (JFR) has not been sufficiently assessed. This study retrospectively reviewed the clinical outcomes of eight patients who underwent an endoscopic-assisted transcervical transparotid approach (EATTA) for management of lesions at the JFR. The study comprised a retrospective analysis of patients who underwent an EATTA for the management of lesions at the JFR. The demographics and perioperative-related indices were analyzed. Benign tumors at the JFR in eight patients were completely removed via EATTA, including two primary and six recurrences. An expanded jugular foramen was detected in three patients. The endoscopic assistance could help enhance exposure of the residual lesions at the JFR and those that extended to the posterior cranial fossa via the expanded foramen. Worsening of preexisting hoarseness (n = 5) and new emergence of Horner syndrome (n = 1) were observed. No intraoperative inadvertent carotid artery injury or CSF leak occurred. Temporary facial nerve palsy was observed in six patients and resolved uneventfully. No recurrence occurred with an average follow-up of 23 months. An EATTA serves as an alternative for the management of benign tumors at the JFR. For select lesions, this approach can also address lesions extending to the posterior cranial fossa via an expanded jugular foramen.