Position And Skin Incision

The patient is positioned supine with the head fixed in the three-point Mayfield headholder (Ohio Medical Instruments, Cincinnati, OH) and rotated to the side contralateral to the tumor (Fig. 82-3). A crescent-shaped incision is marked extending from above the ear curving posteriorly and inferiorly behind the ear and extending into the neck across the rostral aspect of the sternocleidomastoid muscle. For tumors with significant anterior extension, the external auditory canal may be transected and oversewn into a blind sac during the opening to gain maximal anterior reflection of the musculocutaneous flap.

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