Figure 2
Figure 2A: The hypoglossal nerve (yellow vessel loop) is seen stretched and tented over the tumor, explaining the patient’s preoperative hypoglossal nerve palsy. It was not possible to further mobilize the tumor with the hypoglossal nerve in this position. The vagus nerve (white vessel loop) can be seen coursing directly into the tumor.
Figure 2B: A straight midline incision was used. The mandible was pre-plated and the dissection was then extended posteriorly along the floor of mouth.
Figure 2C: The external carotid artery was displaced anteriorly and is seen running over the tumor, consistent with preoperative imaging.
Figure 2D: Ligation of the external carotid artery permitted delivery of the tumor.
Figure 2E: The final operative site after extirpation is shown with view to the jugular foramen.
Figure 2F: Gross pathology specimen demonstrated a well-encapsulated, round, tan tumor 7.9 cm in greatest dimension.