Anterior displacement of the mandible for better exposure of the distal segment of the extracranial carotid artery.

Anterior displacement of the mandible (ADM) was performed in 34 patients undergoing surgery for malformations or atheromatous lesions of the distal segment of the extracranial internal carotid artery (ICA). This procedure greatly facilitates surgical access to the upper cervical region and has several advantages over mandibulotomy-mandibulectomy, namely: A shorter operating time, sparing of the inferior alveolar nerve and of the mandibular branch of cranial nerve VII, with no need for post-operative immobilization of the mandible. ADM permits the correction of ICA lesions extending as far as the first cervical vertebra. For lesions extending into the carotid canal ADM needs to be supplemented by various other procedures via the base of the skull.