Cerv 05

1. LATERAL RETROPHARYNGEAL
APPROACH –
WHITESIDES APPROACH
BASED ON HENRY’S APPROACH TO VERTEBRAL ARTERY
1) Hockey stick incision transversely across mastoid process –
carried distally along anterior border of SCM (approach done
bilaterally)
1) Greater auricular nerve identified and retracted cephalad
2) SCM detached from mastoid process/ identify CN XI I
M
enter SCM 3cm distal to mastoid process
4) Blunt dissection down to the level of the anterior border of
C1, C2 transverse processes, posterior to carotid sheath to
allow entry into the retropharyngeal space

3. STERNOCLEIDOMASTOID
MUSCLE
GREATER AURICULAR
NERVE
Skin incision for lateral retropharyngeal approach of Whitesides.

5. TRANSVERSE SPINAL ACCESSORY PROCESS OF C1
EAR
NERVE
STERNOCLEIDOMASTOID
MUSCLE DIVIDED
The sternocleidomastoid muscle has been divided,
illustrating the coursing of the spinal accessory nerve.

7. LONGUS COLLI MUSCLE C1 TRANSVERSE PROCESS
The C1 lateral process is exposed.
SPINAL ACCESSORY
NERVE
INTERNAL
JUGULAR
VEIN
MIDDLE
SCALENE
MUSCLE

9. PAROTID GLAND
STERNOCLEIDOMASTOID
CAROTID MUSCLE
SHEATH
ARCH OF C1
ODONTOID
PROCESS
VERTEBRAL
ARTERY
A transaxial view illustrating the course of surgical exposure.

10. PAROTID GLAND
STERNOCLEIDOMASTOID
CAROTID MUSCLE
SHEATH
ARCH OF C1
ODONTOID
PROCESS
VERTEBRAL
ARTERY
A transaxial view illustrating the course of surgical exposure.