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Fig 2. Carotid fixation. This patient who had recurrent thyroid cancer in the left side of the neck demonstrates effacement of the fat planes around the left CCA laterally (black arrow). Nonetheless, the tumor does not extend greater than 270° around the circumference of the carotid artery, and the tumor was able to be stripped off the carotid artery at surgery. Note also the tumor abutting the anterior scalene muscle on the left side (white arrow). In many instances, the head and neck surgeons believe that this is a contraindication for further surgery due to the potential for brachial plexus involvement.
