ABSTRACT
Some surgeons have proposed a transverse incision that fells nicely into skin creases in the anterior triangle of the neck. This is a reasonable approach; however, it entails a greater degree of difficulty to gain a high exposure, usually necessitating the use of an assistant pulling up rather heavily with army-navy retractors to expose the distal internal carotid artery (ICA) in a high case. The face and head must be turned radically to the contralateral side in order to swing the ICA out into a more accessible position for this type of exposure. Exposure of the sternocleidomastoid muscle is the key to successfully isolating both the jugular vein and carotid artery in the neck. Once the platysma has been sharply divided, a fatty layer is customarily encountered overlying the sternocleidomastoid edge. Surgery for a relatively low bifurcation of the common carotid artery may expose the omohyoid muscle.
