![]() ![]() Turning the head toward the opposite side draws the mandibular ramus well below the mandible and increases the possibility of facial nerve injury. Nerve damage by retraction or surgical dissection can cause temporary or permanent dysfunction. The mandibular ramus of the facial nerve is vulnerable to injury during this operation. The surgeon must be aware of the location of important cranial and somatic nerves during carotid endarterectomy. Thus, a skin incision placed along the anterior border of the sternocleidomastoid muscle facilitates exposure of the carotid sheath. ![]() Normally, the sternocleidomastoid muscle, the posterior belly of the digastric muscle, and the omohyoid muscle bound the carotid bifurcation. The common carotid artery bifurcates approximately 2.5 cm below the angle of the mandible. ![]()
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