Vascular Exposure - Neck
- An incision is made along the anterior to the sternocleidomastoid and dissection carried down to the carotid sheath.
- The common facial vein is ligated and the carotid sheath opened while care is taken to avoid the vagus nerve (CN X) posterior to the common carotid artery within the sheath.
- The common carotid artery is dissected with care taken to avoid manipulating the artery and causing plaque embolization.
- Sharp dissection is performed distally to isolate the internal and external carotid arteries with knowledge that the hypoglossal nerve (CN XII) will cross the internal carotid artery distally.
- In exposing the internal carotid artery, excessive traction on the sternocleidomastoid muscle should be avoided so as not to cause a traction injury of the spinal accessory nerve (CN XI).