Abstract:Objective To provide anatomic evidence for appropriate selection of the surgical approach to resecting the lesions in the jugular foramen region via exposing the jugular foramen region with different surgical approaches. Methods Six adult cadaveric heads (12 sides) were randomly assigned to three groups (Group A, B, and C). The transcervicaltransmandibular (TCM) approach was applied to Group A, the hypotympanic (HT) approach and modified hypotympanic (MHT) approach to Group B, and infratemporal fossa type A approach (ITFTA) and modified infratemporal fossa type A (MITFTA) approach were used to Group C. The exposure degree of the jugular foramen region and the surrounding anatomic structure were compared among abovementioned surgical approaches. Results The TCM approach offered a good view of the extracranial areas of the jugular foramen and the parapharyngeal space. The HT approach not only provided an excellent view of abovementioned areas as the TCM approach, but also provided a good anatomic view of the mastoidal process, vertical segment of sigmoid sinus, glomus jugular, and pars nervosa of the jugular foramen. The ITFTA approach could provide clear visualization of the above mentioned anatomic structure. Besides, this approach could provide further exposure of the deep areas of the external auditory canal, middle ear cavity, and vertical part of the petrous segment of the internal carotid artery. The MHT and MITFTA approaches not only provided a panoramic view of the all abovementioned anatomic structure, but also offered a better exposure of the areas of the horizontal segment of sigmoid sinus and pars vascularis of the jugular foramen. Conclusion The exposure degree of jugular foramen region varies in different surgical approaches. Therefore, the surgical approach should be selected according to different lesions of the jugular foramen, to optimize the exposure and removal of lesions and to minimize the traumat of the anatomic structure.