Variations in the course of the hypoglossal nerve: a case report and literature review

The extracranial hypoglossal nerve has a well described course as it traverses the neck, and is frequently identified during neck dissection, carotid endarterectomy and other procedures involving the deep spaces of the neck. A case is presented which demonstrates aberrancy of its anatomic position. Variations of its course are well documented, however none have demonstrated a course lateral to the internal jugular vein. This serves to alert the surgeon to be mindful of such atypical presentations as the consequences of iatrogenic injury to such structures may be significant.